Medicaid State Plan Amendments

This amendment is to remove the High Fidelity Wrap-a-round (HFW) language from the Health Home SPA since it will now be a part of a new 1115 to prevent duplication of services.

This amendment proposes to align the Alternative Benefit Plan (ABP) with the Medicaid state plan by clarifying the benefit descriptions for cardiovascular and pulmonary rehabilitation services.

This amendment aligns the Alternative Benefit Plan (ABP) with the Medicaid state plan by adding Diabetes Prevention Program (DPP) services for adults ages 18 years and older who meet certain federal Centers for Disease Control and Prevention (CDC) Diabetes Prevention Recognition Program (DPRP) eligibility criteria.

This amendment will create a Hospital Augmented Reimbursement Program for private hospitals to preserve the financial resources many Texas hospitals depend on to provide access and quality care to Medicaid clients.

The proposed amendment will allow the Texas Health and Human Services Commission (HHSC) to make Medicaid Direct Graduate
Medical Education payments to non-government owned or operated teaching hospitals.

This SPA provides temporary rate adjustments for long term care providers who are undergoing closures, mergers, consolidations, acquisitions, or restructuring themselves.

To remove the requirement of charging premiums on a sliding fee scale for participants to contribute to the cost of medical assistance for the TWWIIA BBA and Basic coverage groups.

This SPA adds mandatory coverage of COVID-19 vaccine and administration, testing, and treatment benefits as required by Section 9811 of the American Rescue Plan Act.

This SPA provides Vermont with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.

This SPA provides Vermont with approval to exempt individuals in the extended postpartum period from cost sharing.