Medicaid State Plan Amendments

This amendment is to suspend temporarily pharmacy co-payments for dates of service starting February 21, 2024, through March 18, 2024, in response to the Change Healthcare cybersecurity incident in alignment with the CMCS Informational Bulletin.

This plan amendment implements a 5% rate increase for licensed Continuing Day Treatment, Day Treatment for Children, and Partial Hospitalization services.

This plan amendment implements a 1% increase to the operating component of most Medicaid rates under the State’s non-institutional state plan section 4.19-B.

This plan amendment implements a 5.4% Cost of Living Adjustment (COLA) for outpatient hospital services, including Outpatient Rehabilitation, and Opioid Treatment Programs.

This plan amendment increases the reimbursement rates for Early Intervention (EI) transportation service one-way trips to authorized EI services.

Will permit the District of Columbia’s Medicaid Program to increase the personal needs allowance standard for eligible institutionalized long-term care residents and set annual increases tied to the federal Cost-Of-Living adjustment (COLA) published by the Social Security Administration.

This plan amendment implements a 5.4% Cost of Living Adjustment (COLA) for mental health and rehabilitative programs.

This SPA is to add genetic counseling services provided by licensed genetic counselors.

To update the fees of health home serving children care management and add an additional tiered fee for health homes serving children providing High Fidelity Wraparound (HFW) as an evidence-based care management service provided to children/youth referred and eligible for HFW within Health Homes Serving Children, by agencies designated by the New York State designation process.

Provides authority to expand eligibility for Group D Targeted Case Management to beneficiaries age 21 to 26, as well as to beneficiaries over age 26 with inherited red blood cell disorders.