Medicaid State Plan Amendments

This Amendment increases the income standard for pregnant women in Medicaid to 200 percent of the federal poverty level.

This amendment proposed to increase its Medically Needy income standards.

This amendment implements a performance standard for qualified entities and hospitals determining presumptive eligibility for the following Medicaid eligibility groups: Parent/Caretaker Relatives, Group VIII Adults, and Former Foster Care Children.

This amendment will revise the Medicaid PACE Rate methodology to ensure that legislatively mandated fee schedule adjustments are reflected in the rates paid to PACE.

This plan amendment adds establishes a cost-based reimbursement methodology for NC Select Drugs, including Cell and Gene Therapies administered in the Hospital Inpatient, Hospital Outpatient, and Professional Outpatient settings.

This plan amendment updates the Family Infant Toddler (FIT) program fee schedules effective February 1, 2025.

This amendment adds Certified Peer Support Specialists and Trainees as providers of Rehabilitative Behavioral Health Services.

This plan amendment will reimburse pharmacists for Medication Therapy Management (MTM) intervention services.

This amendment implements a new prenatal plus program for eligible Medicaid and Children's Health Insurance Plan (CHIP) mothers determined by a health care provider to be at risk of having negative maternal or infant health outcomes.

This state plan amends the fee schedules for services listed on the Introduction Pages.