Medicaid State Plan Amendments

This amendment is to reduce the income standard for the parents and caretaker relatives eligibility group from 155 percent of the federal poverty level to 133 percent of the federal poverty level.

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 proposed new disregards for Medicare Savings Program eligibility groups.

This SPA allows Alaska to enter into value/outcome-based contracts with pharmaceutical manufacturers on a voluntary basis.

This amendment adds on and off-island outpatient dialysis services to within dialysis clinics and Free standing ESRD clinics. Additionally, this amendment makes technical edits to dental services in the state plan.

This amendment proposes to remove the medically monitored detoxification services from rehabilitative services benefit. This level of care will be provided in inpatient settings, aligning with the ASAM levels of care outlined in the state's 1115 SUD demonstration.

This amendment adds doula service coverage for adoptive parents of infants.

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

This SPA allows coverage of select prescribed drugs that do not meet the definition of covered outpatient drugs. Additionally, this SPA also allows reimbursement of prescribed drugs with the same reimbursement methodologies as covered outpatient drugs.

Clarifications and updates to the Prepaid Inpatient Health Plan and fraud detection language.