Medicaid State Plan Amendments

This SPA implements an alternative payment methodology (APM) for Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) for a supplemental payment at the Medical Assistance (MA) program fee schedule rate for a Long-Acting Reversible Contraceptive (LARC) device and its insertion, or the removal of a LARC device, in addition to payment for an encounter.

This plan amendment updates rates for Physician, Free Standing Birth Centers, Early and Periodic Screening Diagnostic, and and Treatment (EPSDT), and Dental Services.

This Amendment decreases the income eligibility standard for certain pregnant women and infants and elect the option described in section 1902(e)(16) of the Social Security Act (the Act) to provide 12 months of postpartum coverage to Medicaid-eligible pregnant individuals.

This plan amendment updates the distribution methodology for the nursing facility incentive program.

This amendment waives the requirement of issuing trauma code mailers for all ICD-9 and ICD-10 trauma codes to recipients when used on claims submitted with the agency that signify an accident may have occurred.

This plan amendment updates the Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program fee schedules

This amendment proposes to remove both quantitative treatment limitations, such as visit limits, and non-quantitative treatment limitations, including prior authorization, concurrent review, and reauthorization requirements.

This amendment revises Oregon’s Tribal Consultation Policy.

This Amendment increases the income eligibility standard for certain pregnant women and infants and deselect the option described in section 1902(e)(16) of the Social Security Act (the Act) to provide 12 months of postpartum coverage to Medicaid-eligible pregnant individuals.

This Amendment memorialize the new income standards for its optional state supplement program, the beneficiaries of which are eligible for Medicaid under Hawaii's state plan.