Table Of ContentDepartment of Social Services
MO HealthNet Division
Fiscal Year 2023 Budget Request
Book 6 of 7
Jennifer Tidball, Acting Director
Table of Contents
TABLE OF CONTENTS
MO HEALTHNET DIVISION – VOLUME 1
Department Request Summary ...................................................................................................................................................... 1
NDI – Managed Care Actuarial Rate Increase............................................................................................................................... 5
NDI – CHIP Authority Cost to Continue ........................................................................................................................................ 14
Core – MO HealthNet Administration ............................................................................................................................................ 21
Core – Clinical Services Program Management ........................................................................................................................... 35
Core – MO HealthNet Transformation .......................................................................................................................................... 45
Core – Third Party Liability (TPL) Contracts ................................................................................................................................. 56
Core – Information Systems ......................................................................................................................................................... 65
NDI – MMIS Operational Costs ..................................................................................................................................................... 78
NDI – MMIS BIS - EDW ................................................................................................................................................................ 82
NDI – MMIS Health Information Exchange ................................................................................................................................... 86
NDI – MMIS Component Upgrades .............................................................................................................................................. 90
NDI – MMIS Interoperability Requirements .................................................................................................................................. 94
NDI – MMIS Identity and Access Management Requirements..................................................................................................... 98
Core – Electronic Health Records Incentives ............................................................................................................................. 102
Core – Hospital Information Technology (HIT) ........................................................................................................................... 113
Core – HITECH ........................................................................................................................................................................... 120
Core – Money Follows the Person .............................................................................................................................................. 127
NDI – Money Follows the Person CTC ....................................................................................................................................... 137
Core – Pharmacy ........................................................................................................................................................................ 141
NDI – Pharmacy PMPM Increase Specialty ............................................................................................................................... 162
NDI – Pharmacy PMPM Increase Non-Specialty ....................................................................................................................... 167
Core – Pharmacy Clawback ....................................................................................................................................................... 172
Core – Missouri RX Plan ............................................................................................................................................................. 182
Core – Pharmacy FRA (PFRA) ................................................................................................................................................... 191
Core – Physician ......................................................................................................................................................................... 198
Core - PACE ............................................................................................................................................................................... 218
Core – CCBHO ........................................................................................................................................................................... 226
Core – Dental .............................................................................................................................................................................. 233
Core – Premium Payments ......................................................................................................................................................... 244
NDI – Premium Increase ............................................................................................................................................................. 257
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TABLE OF CONTENTS
MO HEALTHNET DIVISION – VOLUME 2
Core – Nursing Facilities ............................................................................................................................................................. 261
Core – Home Health ................................................................................................................................................................... 277
Core – Nursing Facilities Reimbursement Allowance (NFRA).................................................................................................... 288
Core – Long Term Support Payments ........................................................................................................................................ 295
Core – Rehab and Specialty Services ........................................................................................................................................ 302
NDI – Hospice Rate Increase ..................................................................................................................................................... 325
Core – Non-Emergency Medical Transportation (NEMT) ........................................................................................................... 329
NDI – NEMT Actuarial Increase .................................................................................................................................................. 342
Core – Ground Emergency Medical Transportation (GEMT) ..................................................................................................... 346
Core – Complex Rehab Technology ........................................................................................................................................... 354
Core – Managed Care................................................................................................................................................................. 364
Core – Hospital Care ................................................................................................................................................................... 380
Core – Physician Payments for Safety Net Hospitals ................................................................................................................. 395
Core – Federally Qualified Health Centers (FQHC) Distribution ................................................................................................ 402
Core – Health Homes .................................................................................................................................................................. 419
Core – Federal Reimbursement Allowance (FRA) ..................................................................................................................... 430
Core – IGT Safety Net Hospitals ................................................................................................................................................. 438
Core – Children’s Health Insurance Program (CHIP) ................................................................................................................. 446
Core – Show-Me Healthy Babies ................................................................................................................................................ 458
Core – School District Medicaid Claiming ................................................................................................................................... 471
NDI – School District Claiming Authority ..................................................................................................................................... 482
Core – Blind Pension Medical ..................................................................................................................................................... 486
Core – IGT DMH Medicaid Program ........................................................................................................................................... 496
Core – MHD Non-Count Transfers ............................................................................................................................................. 503
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Department Request
Summary
