Medicaid State Plan Amendments

This plan proposes updates to remove the “Behavioral Health Utilization Controls” payment reductions for clinics.

To transition the New York State Medicaid non-emergency medical transportation (NEMT) program from an administrative- services only model to a risk-based broker model authorized pursuant to Section 1902(a)(70) of the Social Security Act.

To revise the State Plan to expand coverage of store and forward services for the purposes of strengthening and sustaining telehealth as a high-quality, cost effective, and consumer-oriented form of care delivery.
 

Pursuant to state legislation that rescinds Medicaid coverage and payment provisions for outpatient health facilities (OHF), this SPA proposes to remove the obsolete Attachment 3.1-A and 4.19-B pages from the Medicaid State Plan.

The purpose of the amendment is to clarify the reimbursement methodology for renal dialysis services as payable outside of the current composite rate due to new and/or expensive technology and high cost drugs.

This plan proposes updates to Ambulatory Patient Group (APG) rates for freestanding clinics and reimbursement for Licensed Mental Health Counselors (LMHCs) services and Licensed Marriage and Family Therapists (LMFTs) services.

This Plan revises the new name of the single state agency to reflect Iowa Department of Health and Human Services.

With this Amendment the state will disregard the resource value of certain vehicles under the authority of section 1902(r)(2) of the Act.

This amendment is to update the state plan to reflect the current Preadmission Screening and Annual Resident Review process.

Skilled Nursing Facilities