Medicaid State Plan Amendments

This plan amendment updates the plan by removing Medicare and other third party (non-Medicaid) ancillary costs from the allowable Medicaid reimbursement for Class I nursing facilities.

This plan amendment updates the plan by revising the Pay-For-Performance Supplemental Medicaid payment methodology to Class 1 nursing facilities from a per-diem add-on dollar amount to a flat per-diem multiplier methodology.

This SPA establishes an emergency interim payment methodology for certain providers affected by the Change Healthcare cybersecurity incident.

This SPA adds coverage of select prescribed drugs that are not covered outpatient drugs, and also adds coverage of prescribed drugs that are not covered outpatient drugs in cases of a drug shortage.

This plan amendment edits the provisions governing reimbursement for hospice services in order to
ensure that the current payment methodology aligns with CMS requirements.

This plan amendment authorizes the Department to increase the funding for supplemental payments to qualifying acute care general hospitals.

This plan amendment will permit the District of Columbia Medicaid program to reimburse public specialty inpatient hospitals at a rate that is fair and reasonable.

CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to extend the waiver of premiums for the Buy-In program for Working Adults with Disabilities and the Buy-In program for Children with Disabilities.

This SPA adds coverage of prescribed drugs that are not covered outpatient drugs in cases of a drug shortage.

This plan amendment extends the Non-Designated Public Hospital Supplemental Fund program for the state fiscal year ending 2025, effective July 1, 2024.