Medicaid State Plan Amendments

Clarifications and updates to the Prepaid Inpatient Health Plan and fraud detection language.

This SPA allows New Jersey to enter into Value-Based Supplemental Rebate Agreements with drug manufacturers on a voluntary basis.

This SPA allows coverage of select prescribed drugs that do not meet the definition of covered outpatient drugs. Additionally, this SPA also allows reimbursement of prescribed drugs with the same reimbursement methodologies as covered outpatient drugs.

This amendment is to renew the District of Columbia's 1915(i) State Plan HCBS benefit.

This plan amendment proposes updates to reflect/align reimbursement for direct school-based health services.

This plan amendment revises tier levels under “Methods & Standards for Establishing Payment Rates” in the 1915(i) Home and Community Based Services section of the Medicaid State Plan.

This plan amendment updates the Mobile Crisis Intervention reimbursement rate.

This plan amendment proposes a payment methodology update to modify the cost reporting periods and rates methodology for new psychiatric, rehabilitation, or long-term care hospitals for Wisconsin's Inpatient and Outpatient Hospital State Plans.

This plan amendment proposes to implement a reimbursement rate for CPT codes related to complex rehab technologies.

This amendment proposed a two-year extension of the exception from establishing a Medicaid Recovery Audit Contractor (RAC) program.