Medicaid State Plan Amendments

Proposes to provide additional payments to non-state government public residential health care facilities.

This state plan amendment updates the Medicare fee schedules, MO Healthnet fee schedules and the National Advisory Service (NDAS) used to determine outpatient reimbursement rates.

To add provider types and services for children and adolescents under age 21 who need autism spectrum disorder (ASD) services.

Update the cost base from 2010 to 2015, the acute rate statewide base price, and the service intensity weights

3% rate increase per state budget bill.

To allow pharmacists and pharmacy interns to provide Medicaid covered services to the limits of their scope of practice.

This SPA proposed to revise the state’s reimbursement rate for physician administered drugs such that it will continually align with the Medicare Fee Schedule reimbursement rate.

Disproportionate Share Hospital (DSH) Payment Adjustments

Medi-Cal reimbursement methodology for State Fiscal Year 2023-24 Diagnosis Related Group? Payments.

This SPA proposes to modify language on the excluded drug coverage pages to reflect coverage of selective medications by referencing the state’s webpage resources instead of listing specific covered medications.