Medicaid Crossover Reimbursement Limits

The Division of Health Care Financing is submitting changes to the Medicaid State Plan, Attachment 4.19-B, 08-015-UT -- Crossover Reimbursement Limits.This change is as a result of legislative budget reduction mandates.

Reimbursement for crossover claims will be limited to the Medicaid fee schedule for the following types of services: nursing homes, ambulatory surgical centers, kidney dialysis, pharmacy, medical transportation, specialized nursing, and QMB Only Services.These services are in addition to services already reimbursed under this methodology.

There is estimated to be an annual fiscal impact reduction of approximately $7,020,000.

This proposed change, if approved, becomes effective on November 1, 2008.

The proposed changes are pending Centers for Medicare and Medicaid Services approval.A copy of the changes may be obtained from Craig Devashrayee (801-538-6641), or by writing the Technical Writing Unit, Utah Department of Health, P.O. Box 143102, Salt Lake City, UT 84114-3102.Comments are welcome at the same address.Copies of the changes are also available at local county health department offices.