Medicaid State Plan Amendments

This amendment adds local county agencies as qualified providers to deliver Targeted Case Management (TCM) services to adults with serious mental illness.

This amendment makes changes to the Medicaid State Plan to allow for pharmacist reimbursement for services and prescriptions of hormonal contraceptive patches and self-administered hormonal contraceptives to eligible Medicaid recipients.

This amendment increased reimbursement for targeted case management, and replaces the phrase “mental retardation and other developmental disabilities” with the phrase “intellectual or developmental disabilities” on the submitted pages.

This plan amendment will permit the District's Medicaid program to provide supplemental payments in Fiscal Year 2024 to Medicaid-enrolled physician groups, with at least five hundred (500) physicians and that contract with a public general hospital located in an economically under-served area of the District to deliver inpatient, emergency department, and intensive care physician services to Medicaid beneficiaries.

This amendment remove all co-payments except those related to delivery of non-emergency services in a hospital emergency room.

To continue the 1915(k) rate model approved in the Disaster relief SPA 22-0022 past the PHE period.

This SPA amendment is to adapt the changes to the eligibility rules for the Former Foster Care children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act.

Annual Rebasing Update

Substance Using Pregnant People - name change from Chemically Using Pregnant Women

This amendment is to remove the High Fidelity Wrap-a-round (HFW) language from the Health Home SPA since it will now be a part of a new 1115 to prevent duplication of services.