Medicaid State Plan Amendments

This amendment is to provide presumptive eligibility for pregnant women.

The purpose of this SPA is to reflect exclusion of the following populations from mandatory managed care enrollment: bone marrow or stem cell transplant recipients and sickle cell disease (SCD) gene therapy recipients.

This amendment allows the Division of Medicaid (DOM) to remove prior authorization language and clarify details for inpatient referrals of physician specialist and inpatient hospital physician visit limits.

This amendment adds provider types and certain supported employment services under the rehabilitative services benefit. The SPA also makes other minor changes to the state plan pages.

This plan amendment updates reimbursement for inpatient acute hospital services for rate year 2025.

This plan amendment updates reimbursement for inpatient acute hospital services for rate year 2025.

This plan amendment updates reimbursement for inpatient acute hospital services for rate year 2025.

This amendment invokes 1902(j) authority to exempt American Samoa from the requirements under 1902(a)(84)(D) of the Social Security Act.

This amendment covers of screening, diagnostic, and targeted case management services for eligible juveniles who are inmates of a public institution in accordance with Section 5121 of the Consolidated Appropriations Act of 2023 and the termination of coverage of targeted case management services provided to adults with mental illness and to youth transitioning out of residential services.

This amendment implements the new third-party liability requirements under the Consolidated Appropriations Act of 2022.