Medicaid State Plan Amendments

This amendment proposed to increase the Medically Needy income limit.

This amendment revises the language concerning nursing facility services to comport with the requirement that nursing facility services are ordered by and provided under the direction of a physician.

This amendment proposes to confirm the state's compliance with Section 5121 of the 2023 Consolidated Appropriations Act (CAA) to provide screening, diagnostic, and targeted case management services to eligible juveniles as defined in 1902(nn) of the Social Security Act.

This amendment eliminates the requirement for Consumer Directed Services Facilitators to have an associate's or bachelor's degree to provide services. Work experience shall be listed as sufficient in the list of requirements.

This plan amendment rescinds the alternative payment methodology (APM) for Federally Qualified Health Centers (FQHCs), Rural Health Centers (RHCs), and Tribal Health Programs (THPs) when COVID-19 vaccines are administered on their own and outside of a billable visit.

This SPA describes coverage and adds per diem reimbursement for private duty nursing care for Early and Periodic Screening, Diagnostic and Treatment (EPSDT) beneficiaries.

This plan amendment updates the methodology for pediatric nursing facility care pediatric facility care currently applies only for members up to age 21.

This plan amendment adds the reimbursement rate for Women, Infants and Children (WIC) supplement.

This plan amendment increases the funding for disproportionate share hospital (DSH) payments to qualifying acute care general hospitals that provide enhanced access to multiple types of medical care in economically distressed areas of the Commonwealth.

This amendment amends vision services providers eligible to order, prescribe, refer or render vision services to include those providing services within their scope of practice per State Law.