Medicaid State Plan Amendments

This amendment is to align the Alternative Benefit Plan with the Medicaid state plan by adding doula services and updates the Federally Qualified Health Centers (FQHC) and Rural Health Clinic (RHC) services category to include associate marriage and family therapist (AMFT) services and associate clinical social worker (ACSW) services.

This amendment proposes to align the Alternative Benefit Plan with the Medicaid state plan by adding asthma prevention services, community health worker services, and coverage of routine patient costs in clinical trials.

This amendment proposes to extend the Recovery Audit Contractor exception for an additional two years through June 30, 2026.

This amendment is to update State Plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.

This amendment adds enhanced mobile crisis services to the Medicaid state plan.

This amendment is to align the Alternative Benefit Plan with the Medicaid state plan by allowing physician assistants, nurse practitioners, and clinical nurse specialists, in addition to physicians, to order home health services, including durable medical equipment and medical supplies.

This amendment is to align the Alternative Benefit Plan with the Medicaid state plan by adding Medication Therapy Management (MTM) under Pharmacist Services.

This amendment will align the Medicaid State Plan with federal law for prior authorizations and prompt payment and will bring California into compliance with the Consolidated Appropriations Act of 2022 (Public Law 117-103). 

This amendment adds Therapeutic Foster Care to Iowa’s Medicaid State Plan as a Rehabilitative Service.

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