Medicaid State Plan Amendments

This amendment is to disregard certain compensation payments from income and resources when determining financial eligibility.

This SPA eliminates the sunset date for approved supplemental payments and Alternative Payment Methodologies (APMs) for trauma screenings and developmental screenings.

This SPA removed Fee-for-Service supplemental payments for safety net programs and moved the payments to state directed payments under managed care.

This plan amendment is an enhanced fee schedule (dental) provided in Iowa non-state-own dentistry clinics located in county with a population over 350,000.

This Alternative Benefit Plan (ABP) amendment complies with Section 11405 of the Inflation Reduction Act (IRA) aligning the new mandatory coverage of Medicaid adult vaccinations and the administration of vaccines for the expansion population under ABP5 benefit, without cost-sharing.

This amendment is to update the state's minimum personal needs allowance for individuals residing in a nursing facility (NF), assisted living facility, intermediate care facilities for individuals with intellectual disabilities (ICFs/IID), or other similar long-term care facility from $60 to $75 for individuals and from $120 to $150 for couples.

This amendment is to add coverage for Community Health Workers/Community Health Representatives as a new reimbursable preventive service at 42 CFR 440.60.

The state raises the income eligibility standard for its Family Planning eligibility group from 133 percent of the federal poverty level (FPL) to 205 percent.

The proposed amendment documents coverage of COVID-19 tests as a benefit in Texas Medicaid, including at-home tests provided through a pharmacy.

This transmittal is being submitted to reflect that client related GME is not included in the MCO capitation.