Medicaid State Plan Amendments

The purpose of this SPA is to incorporate updates that were made in previously approved SPA WA-23-0010 to the service names and practitioners related to rehabilitative services that are delivered using a managed care delivery system. In addition, SPA WA-23-0051 corrects page number references and adds practitioner types to align with practitioners that have been added to the Other Licensed Practitioners section of the State Plan since the Managed Care section was last updated.

To disregard refunds issued by the state to individuals who incurred Medicare-related premiums, deductibles, and co-payments as a result of not having been enrolled in the appropriate Medicare Savings Program eligibility group.

Adds language specifically stating that for beneficiaries under 21 years of age, there are no limits for medically necessary home health nursing services, medically necessary home health aide services, medically necessary home health physical therapy, occupational therapy, speech pathology and audiology services.

This amendment covers the Continuous Glucose Monitors (CGM) under the Durable Medical Equipment (DME) benefit.

Uniform Cost Reporting Update

Nursing Home Reforms

SFY 2024 Charity Care Subsidy

This SPA corrects a typographical error that was made in MO SPA 23-0030, relating to the resource standard for a couple in the Ticket to Work Basic and Medical Improvements eligibility groups.

This state plan amendment amends 7.7-A of the Vaccine and Vaccine Administration at Section 1905(a)(4)(E) of the Social Security Act template to remove CPT 99401 with modifier CR from the SPA language.

This amendment adds enhanced mobile crisis services to the Medicaid state plan.