Medicaid State Plan Amendments

This SPA amends the State Plan to add coverage of select weight loss medications.

This amendment is to add Licensed Professional Clinical Counselors (LPCCs) to the list of billable practitioners providing services at Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs) and Tribal FQHCs.

This amendment is to expand the prescribing authority for enteral formulae from physicians to include physicians, nurse practitioners, clinical nurse specialists, or physician assistants.

Updates the description of Peer Support Services and revises the qualifications and licensing requirements for Certified Peer Specialists.

Adds an assurance that the Department of Medical Assistance Services will make coverage and billing code modifications when the Advisory Committee on Immunization Practices (ACIP) and/or U.S. Preventive Services Task Force (USPSTF) “A” and “B” recommendations change. The amendment also makes a technical change to revise reference to section “4016” of the Patient Protection and Affordable Care Act to section “4106.”

DESCRIPTION: Proposes several changes to update, clarify, and streamline language in the state plan. The proposed changes include: 1) streamlining language that describes certain therapy modalities, which are available under the Counseling/Therapy service benefit, 2) updating supervision requirements for behavioral health providers in Federally Qualified Health Centers (consistent with District Law), 3) clarifying education and experience requirements for credentialed staff able to provide State Plan rehabilitative services, and 4) updating rates for select behavioral health services according to the fee schedule.

This SPA is to add Pharmacists as allowable providers to perform Medication-Assisted Treatment for Opioid Use Disorder.

This plan amendment updates the Opioid Treatment Program (OTP).

Proposes eliminating all cost-sharing except for copays associated with pharmacy and non-emergency use of the Emergency Room.

This plan amendment implements an 8% rate increase, provided through the Maryland Budget Bill and the Governor's Supplemental budget, for the 1915 Home and Community-Based Services Program.