Medicaid State Plan Amendments

Proposes to update the STRIVE per diem staffing add-on portion of the nursing facility rate and the real estate tax component of the nursing facility payment rate.

This amendment adds Certified Family Partner Services as a new Texas Medicaid benefit.

This amendment streamlines requirements for the Biopsychosocial Treatment of Obesity program to remove administrative burden to improve accessibility of services for participants.

This amendment assures coverage for clinic services outside of the "four walls" of Indian Health Service (IHS)/ Tribal clinics.

This plan amendment updates long-acting reversible contraceptive devices provided immediately postpartum at an acute care hospital which are exempt from the DRG payment method and are reimbursed via the fee schedule.

This amendment makes requirements for physical therapy services consistent with requirements for Medicaid home health
services.

This plan amendment amends the provisions governing reimbursement methodology for intermediate care facilities for individuals with intellectual disabilities (ICF/IID) in order to provide for a one-time lump sum payment in fiscal year 2025, to all privately owned or operated ICF/IID that billed Medicaid between August 1, 2024 and October 31, 2024, and are active and Medicaid certified at the time of payment.

This amendment proposes to assure coverage for clinic services outside of the “four walls” of behavioral health clinics or clinics located in rural areas.

With this amendment, the state is expanding 1915(i) eligibility to youth with a history of foster care and probation
involvement.

This amendment updates Attachments 3.1-A, 3.1-B, and 4.19-B pages of the Medicaid State Plan to comply with federal regulation 42 CFR 440.169 and establishes a new target case management benefit for children in Tennessee who are receiving early intervention services.