OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES
Notice of Changes in Methods and Standards for Medicaid Payments for
Medical Equipment (ME), Medical Supplies, and Vision Supplies
In accordance with public notice requirements established at 42 CFR 447.205, the Indiana Family and Social Services Administration, Office of Medicaid Policy and Planning (OMPP) publishes this notice of proposed changes to methods and standards governing reimbursement policy for Medicaid payments for medical equipment (ME), medical supplies, and vision supplies. This public notice period will run 10/02/2019 – 11/01/2019. This change will be effective 10/03/2019.
OMPP proposes to revise the Medicaid payment rates for medical equipment (ME), medical supplies, and vision supplies (spectacles, lenses, etc.) by implementing the Medicaid fee schedule amount in effect on July 1, 2013. If that amount is not available, Medicaid reimbursement shall be established using the following formula:
(1) The Indiana Medicare fee schedule amount adjusted by a multiplier of eight-tenths (0.8), if available. If this amount is not available, then
(2) The average acquisition cost of the item adjusted by a multiplier of one and two-tenths (1.2), if available. If this amount is not available, then
(3) The manufacturer's suggested retail price adjusted by a multiplier of seven-and-one-half-tenths (.75). If this amount is not available, then
The invoice cost of the item adjusted by a multiplier of one and two-tenths (1.2).
It is estimated that the fiscal impact of these changes will be a decrease in state and federal expenditures of approximately $118,000 for federal fiscal year 2020 (federal share of $78,000 and state share of $40,000) and $177,000 for federal fiscal year 2021 (federal share of $117,000 and state share of $60,000).
A copy of this notice is now on file at the Indiana Government Center South, 402 West Washington Street, Room W451 and is open for public inspection. Also, a copy of this notice is now available and may be inspected by contacting the local county Division of Family Resources office, except in Marion County, where public inspection may be made at 402 West Washington Street, Room W374, Indianapolis, Indiana.
There will be no public hearing. Written comments may be directed to FSSA, Office of Medicaid Policy and Planning, Attention: Amy Owens, 402 West Washington Street, Room W382, P.O. Box 7083, Indianapolis, IN 46207-7083 or by email to spacomments@fssa.in.gov. Correspondence should be identified in the following manner: COMMENT RE: MEDICAL EQUIPMENT AND MEDICAL SUPPLIES REIMBURSEMENT CHANGES. Written comments will be made available for public inspection at the address herein of the OMPP.
Jennifer Sullivan, MD, MPH
Family and Social Services Administration
Posted: 10/02/2019 by Legislative Services Agency
DIN: 20191002-IR-405190504ONA
Composed: Apr 26,2024 11:33:37PM EDT
A
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