Medicaid State Plan Amendments

This SPA establishes a partial benefit package of family planning and family planning-related services to individuals whose income is at or below 208% of the federal poverty level.

To provide 12 months of continuous eligibility for children under age 19 in Medicaid. This amendment will align state policy and practices with federal requirements under section 5112 of the Consolidated Appropriations Act, 2023.

To implement 12-months of continuous eligibility for children as required by the 2023 Consolidated Appropriations Act. This SPA also makes a technical change to note that the Virginia Department of Medical Assistance Services processes the eligibility applications of individuals who are returning to the community after a period of incarceration. Additionally, this SPA makes technical corrections to the "Eligibility Determinations and Fair Hearings" and "Organization and Administration" reviewable units approved in VA-23-0007 regarding Virginia's transition to a new State-Based Exchange.

This amendment updates the coverage of preventive services when recommended by a physician or other licensed practitioner.

The purpose of this SPA is to amend the provisions governing disproportionate share hospital (DSH) payments to establish the qualification criteria and methodology for payments for the uncompensated care costs of inpatient psychiatric hospitals located in the northern area of the state with an academic training mission for services provided to uninsured and low-income individuals from the payment pool created in accordance with Act 447.

This state plan amendment incorporates additional funding for the Quality Incentive Budget as outlined in the state’s annual appropriations act and makes additions to the existing system of Quality Incentive Add-on Calculations.

This amendment Maternal Life 360 Home to include new targeted case management program for pregnant women.

This amendment is to approve the paper and online single streamlined applications used to apply for insurance affordability programs.

This amendment is to add coverage of community-based mobile crisis services. This aligns the state’s Alternative Benefit Plan (ABP) with approved SPA 24-0005.

This SPA revises the amount for the personal needs allowance (PNA) provided to certain recipients in nursing facilities. The amendment will allow for COLA increases annually.