Posts tagged: 2011

Medicare DRG Table 2011 2019

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By , December 21, 2019 7:35 am


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Medicare DRG Table 2011 2019

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(FY) 2019 Inpatient Prospective Payment System (IPPS) – CMS.gov

Oct 3, 2018 … 1A-C and Table 1D, respectively, of the FY 2019 IPPS/LTCH PPS Final …
implementing 18 new MS‑DRGs for FY 2019 and deleting 11 MS-DRGs. …..
documentation and coding adjustment factor for FYs 2011 through 2014 of …

CMS Manual System – CMS.gov

Oct 8, 2018 … MS-DRGs available on the FY 2019 Final Rule Tables webpage. …. and coding
adjustment factor for FYs 2011 through 2014 of 0.9480.

(FY) 2018 Inpatient Prospective Payment System (IPPS) – CMS.gov

Sep 11, 2017 … 1A-C and Table 1D, respectively, of the FY 2018 IPPS/LTCH PPS Final Rule,
available on the … Reduced the number of MS-DRGs from 757 to 754 for FY
2018. ….. adjustment factor for FYs 2011 through 2014 of 0.9480 and apply all of
the updates and DRG …. beginning during FY 2018 and FY 2019.

Medicare Claims Processing Manual – CMS.gov

Capital payments are based on the same DRG designations and weights, ….. 1)
Identify total Medicare inpatient capital cost from Worksheet D Part 1, column 10,.

Federal Register/Vol. 82, No. 155/Monday, August 14, 2017/Rules …

Aug 14, 2017 … the IPPS tables and LTCH PPS tables are ….. FY 2019. 14. Review of Procedure
Codes in MS. DRGs 981 Through ….. (2011, 2012, and 2013).

Federal Register/Vol. 83, No. 89/Tuesday, May 8, 2018 … – GovInfo

May 8, 2018 … Medicare Program; FY 2019 Inpatient. Psychiatric Facilities Prospective …. 4 to
this proposed rule show the tables ….. On May 6, 2011, we published a final rule
in the ….. the IPF PPS to adopt the new MS–DRGs. For a detailed …

Hospital Inpatient Prospective Payment System – GovInfo

Apr 27, 2016 … … FY 2012, some of the IPPS tables and LTCH PPS tables are …. related group.
MS–LTC–DRG Medicare severity long-term ….. Measures for the FY 2019
Program Year a. …… claims data for the FY 2011 IPPS/LTCH. PPS final …

Proposed rule – Amazon S3

3 days ago … Medicare Program; FY 2020 Inpatient Psychiatric Facilities … during the fiscal
year (FY) beginning October 1, 2019 through September 30, 2020 ….. The patient
-level adjustments include age, Diagnosis-Related Group (DRG) ….. (Worksheet
B, part I, column 26, line 40) and a portion of total ancillary costs.

Hospital inpatient and outpatient services – MedPAC

TABLE. 3–1. Growth in Medicare inpatient and outpatient spending. Hospital
services. 2006. 2014 … base MS–DRG (the categories are no CC, a nonmajor.

Chapter 14: Finances – Texas Health and Human Services

Source: U.S. Centers for Medicare & Medicaid Services, Historical National
Health …. 2011. $24,816. $95,461. 26.00%. 2012. $25,438. $92,914. 27.38%.
2013 …. Table 14.2: Medicaid Timeframes in the 2018-2019 Budget Process …..
DRGs. Children's hospital payments are based on the standardized average cost
of …

psi – AHRQ – Quality Indicators

Jun 2, 2018 … 1.0 Log of ICD-9-CM, ICD-10-CM/PCS, and MS-DRG Coding Updates … The
following table summarizes all of the revisions made to the Patient …

Report to Congress on Medicaid and CHIP March 2019 – macpac

Mar 15, 2019 … controls to ensure that annual hospital upper payment limit demonstration data
are accurate …. of a fixed amount (Bachrach and Dutton 2011;. MACPAC …. and
about half used a price-based method (Table … hospital by DRG.

SFY 2019 Budget Recommendation – Department of Vermont Health …

Jan 25, 2018 … Budget Recommendation – State Fiscal Year 2019 ….. approved by CMS,
allowing Vermont to continue these programs, which …… The following table
provides the January 2018 FPL information as an example of household ……
payments to providers for Program Year 2011, and will be issuing payments to.

CHAMPVA Guide – VA.gov

Cost Summary—When You Have OHI (Other Than Medicare). CHAMPVA … The
Table of Contents lists topic areas by section, ….. 08/20/2011 …… the DRG rate.

Missouri Secretary of State: Code of State Regulations

Dec 31, 2018 … The DRG weights will be updated annually ….. Medicaid worksheet in the
hospital's cost …… HealthNet patient days, remove the SFY 2019.

njddcs data dictionary – State of NJ

Indication of how inpatient has been grouped using MS-DRG in effect at the time
…. HCPCS codes must be in CCE Procedure Code Table. …… 2019 UNION
TOWNSHIP ….. principal diagnosis code, effective with discharges on/after 1/1/
2011.

National Efficient Price Determination 2018-19 – Independent …

Mar 19, 2018 … Independent Hospital Pricing Authority 2018 … 131(1) of the National Health
Reform Act 2011 (Cth). … Appendix H – Price weights for admitted acute patients
– AR-DRG V9.0….. 43 …… These price weights are used to calculate NWAU for
patients who are not discharged at 30 June 2019 and have a length …

Hospital Services – SCDHHS.gov

Established April 1, 2005. Updated April 1, 2019 ….. providers to the Hospital
Provider Manual webpage. 05-01-18. Forms ….. Replaced APR-DRGs and
Relative Weights table. 11-01-15 Appendix …… Medicaid Bulletin dated March 16
, 2011 –.

Medicare Claim Adjustment Codes 2011 2019

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By , December 9, 2019 10:59 am


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Medicare Claim Adjustment Codes 2011 2019

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Medicare Claims Processing Manual – CMS.gov

Items 14 – 33 … ASCA exception may send their claims to Medicare on a paper claim form. …
submit ICD-10-CM codes for claims with dates of service prior to …… Beginning
with dates of service on and after January 1, 2011, for …… Group Code CO, Claim
Adjustment Remark Code (CARC) 16, and …… 03/12/2019 11129.

Medicare Claims Processing Manual Crosswalk – CMS

for coverage determination, payment, and/or denial action. It sends to the A/B …
This section contains Medicare requirements for use of codes maintained by the
NUBC that are needed …… R4194CP 01/11/2019 Update to Publication (Pub.)
100-04 … R2250CP 07/01/2011 Non-systems Internet Only Manual (IOM).
Changes.

CMS Manual System – CMS.gov

Jan 7, 2011 … 100-04 Transmittal: 2131 Date: January 7, 2011 … Medicare policy states that
Claim Adjustment Reason Codes … changes that have been approved since the
last code update CR (CR 7089 Transmittal 2019), and does not.

FEE-FOR-SERVICE PROVIDER BILLING MANUAL … – ahcccs

Apr 13, 2018 … REVISION DATES: 1/11/2019; 4/13/2018; 3/20/2018; 3/12/2014; 2/21/2014 …
register their National Provider Identifier (NPI) with Medicare and must bill …..
Medicare reason codes carefully to determine if the Medicare appeal …

Claim Adjustment Reason Codes and Remittance … – Mass.gov

Jan 1, 2019 … Claim Adjustment Reason Codes and Remittance Advice Remark Codes (CARC
and RARC)–Effective 01/01/2019. EOB. CODE. EOB CODE DESCRIPTION …..
MEDICARE DEDUCTIBLE AMOUNT. MISSING-DETAIL. 16 …… 2011. PHARMCY
MEDICAL/NON-MEDICAL. SUPPL. AND ROUTINE DME. 204.

Proposed rule – Amazon S3

Jul 27, 2018 … Other Revisions to Part B for CY 2019; Medicare Shared Savings … and services
furnished by nonexcepted off-campus provider-based …. Throughout this
proposed rule, we use CPT codes and descriptions to refer to a variety of … PFS,
incorporating geographic adjustments to reflect the variations in the …

General Billing Instructions – Idaho Medicaid Health PAS OnLine

Jan 17, 2019 … Idaho Medicaid Provider Handbook. General Billing Instructions. Janaury 17,
2019. Page i …. Medicare Processing . … Adjustments of Paid or Denied Claims .
… Determining How to Bill Units for 15-Minute Timed Codes . …… Dental services
are administered through Idaho Smiles as of July 1, 2011.

Appendix for SEER-Medicare 10/2018 Claims Files – Healthcare …

… 10/2018 Claims Files. February 22, 2019 …. Employee: a Medicare beneficiary
who is still working or a worker who died before retirement …. NOTE: Effective 4/1
/02, the Carrier claim payment denial code was expanded to a 2-byte …. 00663 =
FQHC Pilot Demo (CAFM – Ayers-Ramsey) (term. 11/2011). 00690 = Maryland …

ForwardHealth Portal HMO Encounter User Guide

Dec 15, 2018 … percentage for 2019. 14.0 … The Centers for Medicare and Medicaid Services (
CMS) is the US Health and … Error Code is the denial issued by a claims/
encounter …… https://www.forwardhealth.wi.gov/kw/pdf/2011-76.pdf.

HEALTH INSURANCE CLAIMS ASSESSMENT ACT – Michigan …

Act 142 of 2011 THIS ACT IS REPEALED BY ACT 173 OF 2018 EFFECTIVE: See
MCL 550.1731a … Michigan Compiled Laws Complete Through PA 2 of 2019 ….
section 220 of the internal revenue code, 26 USC 220, a medicare advantage ….
subscriber is inaccurate due to subsequent claim adjustments or recoveries, …

Child Core Set – Medicaid.gov

Feb 8, 2019 … The UB Codes in the Child Core Set specifications are included … HHSM-500-
2005-PA001C with the Centers for Medicare & Medicaid Services. … 2019
American Dental Association on behalf of the Dental Quality … Claim Committee (
NUCC) Health Care Provider Taxonomy codes …… Risk adjustment.

New York State Medicaid Update September 2018 Volume 34 …

Oct 1, 2018 … enrolled in both Medicare and Medicaid will return the new Medicare Beneficiary
… Until 12/31/2019, if the MBI is not available for the client, the HICN (Health …..
CARC 29 (Claim Adjustment Reason Code 29) with no Remittance ….. Since
2011, Eligible Professionals & Eligible Hospitals have received:.

Hospital Services Manual – Utah Medicaid – Utah.gov

Utah Medicaid Provider Manual … Updated January 2019 ….. Outpatient and
Inpatient Hospital Revenue Codes . …. CMS Laboratory Fee Schedule are the
only laboratory services with a separate …. Manual Adjustments Accepted … A.
Effective September 1, 2011, Utah Medicaid began paying outpatient hospital
claims like.

H.R. 2: The Medicare Access and CHIP Reauthorization Act of 2015

Mar 26, 2015 … Title I—SGR Repeal and Medicare Provider Payment Modernization . ….. relative
values to each of the approximately 7,500 service codes that reflect …. For EHR
adopters in 2011 and 2012, eligible physicians ….. MIPS adjustment factor (
positive or negative) would be 4% in 2019, 5% in 2020, 7% in 2021,.

Long-Term Care – IN.gov

(CMS) design and define the following for the Long Term Care (LTC) program: …
Level of Care Screening Procedures for Long Term Care Services Provider
Manual) …. following an LOC denial) may be reimbursable if the resident is found
to be ….. determination pursuant to Indiana Code IC 4-21.5-3-7 and 405 IAC 1-
1.5.

Physician-Related Services — Health Care Professional Services …

Oct 16, 2018 … To download an agency provider form, go to HCA's Billers and provider's web
page, select …… The agency follows the CMS MUEs for all codes. ….. Effective
January 1, 2019. Existing ….. with the reason for the visit and the outcome of the
visit. ….. There are five core principles to CoCM developed in 2011 in …

State and CMS Oversight of the Medicaid Managed Care …

May 29, 2018 … MCOs paid Medicaid claims without a matching EVV transaction. Payers can …
performance. The inspection found that reason codes are not properly used ….
2019, and home health services by January 1, 2023. … Session, 2011, directed
DADS to pilot EVV and, if cost effective, to implement it in a wider …

Missouri Secretary of State: Code of State Regulations

Mar 31, 2019 … 13 CSR 70-3.100 Filing of Claims, MO HealthNet Program . ….. Medicaid,
Medicare, or any other public or … denial of enrollment by the single state agen-
…… (Rescinded June 30, 2011) …. 28, 2018, effective April 30, 2019.

Medicare Ambulance Fee Schedule 2011 2019

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Medicare Ambulance Fee Schedule 2011 2019

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Ambulance Fee Schedule – CMS.gov

Dec 31, 2017 … Learn about these Ambulance Fee Schedule. (FS) topics: … The Medicare Part B
ambulance transport benefit … on January 1, 2011.

Medicare Claims Processing Manual – CMS.gov

Jan 18, 2019 … 20.1.4 – Components of the Ambulance Fee Schedule. 20.1.5 – ZIP Code … (IOM),
Pub. 100-02, Medicare Benefit Policy Manual, chapter 10.

Ambulance Inflation Factor for Calendar Year 2019 and … – CMS.gov

Nov 30, 2018 … to Medicare Administrative Contractors (MACs) for Medicare Part B ambulance
services … CR 11031 furnishes the Calendar Year (CY) 2019 Ambulance
Inflation … productivity (MPF) beginning January 1, 2011. … Section 3401 of the
ACA requires that specific Prospective Payment System (PPS) and Fee.

Federal Register/Vol. 83, No. 145/Friday, July 27, 2018/Proposed …

Jul 27, 2018 … to the ambulance fee schedule. Corinne Axelrod, (410) … G. Payment Rates
Under the Medicare PFS for Nonexcepted … For the CY 2019 PFS Proposed
Rule, refer to item …. 2011 PFS final rule with comment period (75 FR …

Department of Health and Human Services – GovInfo

Jul 15, 2015 … Medicare Program; Revisions to Payment Policies Under the Physician Fee.
Schedule and Other …. the Ambulance Fee Schedule …… effective CY 2016
through CY 2019, assuming ….. In the CY 2011 PFS proposed rule (75.

Medicare Payment Updates and Payment Rates – Every CRS Report

Sep 27, 2012 … Medicare is a federal insurance program that pays for covered health … The
method for updating the physician fee schedule amount, known as the …..
Ambulance Services. ….. budget window (FY2010-FY2019), based on a CRS
analysis of the … tasked it with providing to Congress by November 23, 2011 …

Fee Schedule – Colorado.gov

Fee Schedule when an individual's vocational rehabilitation needs are such that
he ….. insurance, Social Security benefits, Medicare, Medicaid, the Veterans ……
NOTE: January 1, 2019, rate changes to $11.10 per hour. …… Grouper rates and
their effective dates. Grouper. January 1 –. June 30,. 2011 … Ambulance services
.

DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for …

F. Medicare Telehealth Services for the Physician Fee Schedule. G. Therapy
Caps …. Updating the Ambulance Fee Schedule regulations. ○ Updating the-.

tennessee's workers' compensation medical fee schedule – TN.gov

Our Medical Fee Schedule is made-up of three (3) parts, called chapters, of
administrative rules. … the basis for the Medical Fee Schedule (Medicare for most
of the Medical Fee Schedule), ….. O. Ambulance Services. …… CMS issued an
emergency update to the 2011 conversion factor that was effective for all dates of
 …

Fee Schedule – City of Fremont

Mar 6, 2019 … 8672. (Fees as amended through March 6, 2019) ….. F. Facility Rental Schedules
Fremont Family Resource Center . …… Res 2011-17, 4/5/11). N/C. ACC. $105/ …..
Emergency ambulance, rescue service, or vicious animal response. ….. receiving
Medi-Cal and Medicare benefits as well as those who do not.

New York State Medicaid Update Volume 34 Number 4 April 2018

Apr 19, 2018 … 2019 for a Medicaid fee increase for both emergency and … The updated fees
effective for dates of service on or after April 1, 2018 are … Enacted Budget
Initiative: Medicaid Transportation Ambulance Rate …. Centers for Medicare and
Medicaid Services (CMS) performance …… Since December 2011, more.

Provider Relations – State of Michigan

Jul 11, 2017 … Providers: The 2019 All-Inclusive (PPS) rates have not been … M on Medicare's
Addendum B. This was fixed in the system update on …… MDHHS will void
identified claims received on or after January 2011 which ….. For ambulance runs
requiring over 250 miles, prior authorization (PA) from the Medicaid.

SFY 2019 Budget Recommendation – Department of Vermont Health …

Jan 25, 2018 … Budget Recommendation – State Fiscal Year 2019. 2 ….. non-fee-for-service
payment models to the Centers for Medicare …. between rates paid to DHMC and
Vermont's in-state academic medical center. …… AMBULANCE …… payments to
providers for Program Year 2011, and will be issuing payments to.

Missouri Department of Social Services Medicaid Fee-for-Service …

Feb 10, 2017 … CMS guidance, MHD will continue to develop more sophisticated analysis … The
Utilization rates for Psychologists, Licensed Clinical Social Workers (LCSWs), …..
Management Information System (MMIS) for Ambulance, Audiology, … on
January 1, 2008, 2009, 2010, 2011, 2012, 2013, 2014 and 2015 and …

2019 UnitedHealthcare Medicare Advantage with Dental … – CalPERS

Jan 1, 2017 … 2019 Evidence of Coverage for UnitedHealthcare® Group Medicare Advantage (
PPO) …… plan covers ambulance services in situations where getting to the
emergency room in any other …… Maximum allowable fee schedules vary
according to geographic area and are a set amount …… 1-515-725-2011.

Medicare and the Health Care Delivery System – MedPAC

Jun 15, 2016 … The Medicare Payment Advisory Commission (MedPAC) is an … Medicare's
traditional fee-for-service program, MedPAC is also ….. Beginning in 2019 and
continuing through 2024, payment ….. rates for primary care visits and ambulance
transports. … 2011, dual eligibles represented about 20 percent of.

CHAMPVA Guide – VA.gov

Cost Summary—When You Have OHI (Other Than Medicare). CHAMPVA and
Medicare … The Table of Contents lists topic areas by section, with
corresponding …

MHCP Fee Schedule – Minnesota.gov

Mar 1, 2002 … SUBJECT – Minnesota Health Care Programs Fee Schedule … The fee schedule
amount for dental exam and dental x-ray services provided on or …. Minnesota
Health Care Programs follows Medicare coverage … AS OF 04/15/2019 …. 1/1/
2011. N. A4221. 01/01/19. 1. 20.27. 1/1/2015. N. A4222. 01/01/19.

Medicaid Spending 2011 2019

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Medicaid Spending 2011 2019

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National Health Expenditure Projections 2012-2022 – CMS.gov

Total Medicaid spending is projected to increase 12.2 percent in 2014.
Enrollment …. 2011. 2012. 2013. 2014. 2015. 2016. 2017. 2018. 2019. 2020.
2021. 2022.

2017 actuarial report on the financial outlook for medicaid – CMS.gov

costs, readers should be aware that actual future Medicaid costs could differ ……
$700. 2005. 2007. 2009. 2011. 2013. 2015. 2017. 2019. 2021. 2023. 2025. E.

Trends in Medicaid Spending – macpac

Jun 16, 2016 … Because Medicaid spending per enrollee varies substantially across ….. By SFY
2011, Medicaid's share …. from FY 2014 through FY 2018 and by 5 percent to 6
percent per year from FY 2019 to FY 2025 (CBO 2016d). Source: …

2011 actuarial report on the financial outlook for … – Medicaid.gov

Mar 16, 2012 … I have the honor of transmitting to you the 2011 Actuarial Report on the Financial
… projections in this report, Medicaid costs will almost certainly …… Projected
spending in 2019 of $811.1 billion is 3.5 percent lower than the.

Medicaid Enrollment & Spending Growth – Kaiser Family Foundation

Oct 1, 2017 … Medicaid Enrollment & Spending Growth: FY 2017 & 2018 … 2005 2006 2007
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 … down to 95
percent in CY 2017, 94 percent in CY 2018, 93 percent in CY 2019,.

Prices for and Spending on Specialty Drugs in Medicare Part D and …

Mar 2, 2019 … Keywords: Medicare Part D, Medicaid, specialty drugs …. Part D and Medicaid. (
March 2019), www.cbo.gov/publication/54964. …. of the increase in total drug
spending between 2011 and 2015 could be attributed to specialty.

The Budget and Economic Outlook: 2019 to 2029 – Congressional …

Jan 25, 2019 … 1999 2001 2003 20052007 2009 2011 20132015 2017 2019 20212023 … In
CBO's projections, the federal budget deficit is about $900 billion in 2019 ……
Assistance Program, Medicaid, Supplemental Security Income, and …

data point – Office of The Assistant Secretary for Planning and …

Jan 12, 2017 … funds allocated it for Federal Fiscal Years (FY) 2011-2019 as early as the first
quarter of FY. 2018. … In Puerto Rico, Medicaid expenditures are.

Overall Medicaid Budget Impact – Ohio.gov

Governor Kasich's first Medicaid budget (enacted in 2011) proposed spending
$500 … 2017, six percent in January 2018, and seven percent in January 2019.

Maine Medicaid Expansion Report – Maine.gov

Jan 10, 2014 … FIGURE 3: MEDICAID EXPENDITURES AS SHARE OF GDP . …… 2020 it would
comprise 3.2% of GDP, up from 2.8% in 2011. For states, Medicaid …… 2019-20.
2020-21. 2021-22. 2022-23. 2023-24. MaineCare En rollm en.

Impact on Alaska of Medicaid Provisions in the House-Passed AHCA

Jun 21, 2017 … expenditures or reduce Medicaid spending by cutting benefits, reimbursements
or eligibility. Under Per … 2019, but eliminates enhanced funding in 2020 except
for “grandfathered” adults: ….. Benefit Enrollee, FY 2000-2011.

Cost Shift Analysis Report – Colorado.gov

January 22, 2019. Table of Contents. Executive ….. cost shift and hospital
overcompensation, more so than Medicaid or Medicare under- ….. CY 2011
2,511.2M.

GAO-15-324, Medicaid and CHIP: Increased Funding in U.S. …

Apr 8, 2016 … Table 2: Federal and U.S. Territory Medicaid and CHIP Spending, ….. available
for expenditure from July 1, 2011, through September 30, 2019.

Assessment of Medicaid Expansion and Reform – Alaska State …

Jan 15, 2016 … Reductions in Non-Medicaid Behavioral Health Costs . ….. Exhibit F. Medicaid
Eligibility Dynamics in Alaska (source: tabulations of 2011 MSIS data) …………….
14 ….. Estimated Expansion Cost Per Person, FY2019. $7,323.

Medicaid and NC Health Choice – NC.gov

Dec 24, 2018 … $45 million under budget, the fifth consecutive year NC Medicaid finished …..
across North Carolina, will focus in SFY 2019 on opportunities to improve ….. SFY
2011 through SFY 2016—and more savings are expected as the.

Agency Profile – Spending by Program Chart – Minnesota.gov

In FY2015 DHS all funds spending was $15.2 billion.i ….. 2011. 2012. 2013. 2014
. 2015. Quality. Percent of children not experiencing … Medical Assistance (MA;
Minnesota's Medicaid program) …… NOTE: The budget structure for DHS Direct
Care and Treatment programs was modified for the 2018-2019 Biennial Budget.
In.

THE MISSOURI BUDGET Elementary and Secondary Education …

That is why the Governor's Fiscal Year 2019 budget increases pay for teachers in
state-run … FY 2009 FY 2010 FY 2011 FY 2012 FY 2013 FY 2014 FY 2015 FY
2016 FY 2017 ….. The Missouri Department of Social Services' Medicaid Program
.

FY 2019 Budget – NJ.gov

State of New Jersey FY 2019 Budget in Brief … The Fiscal 2019 Budget. …..
comprehensive Autism Spectrum Disorder (ASD) services for Medicaid-eligible
youth. …. FY2010 FY2011 FY2012 FY2013 FY2014 FY2015 FY2016 FY2017
FY2018 …



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