Medicaid State Plan Amendments

This amendment aligns the Alternative Benefit Plan for 19- 20-Year-Old Medicaid Expansion Members.

This state plan amendment clarifies coverage of crisis intervention services and service rates.

This amendment revises the Medicaid State Plan to ensure that laws are in effect barring third-party payers from refusing payment for an item or service solely because it did not receive prior authorization under the third-party payer's rules.

This amendment provides coverage without cost sharing for adult vaccines and their administration for all U.S. Food and Drug Administration approved adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP). 

This amendment provides coverage of all vaccinations recommended by the Advisory Committee on Immunization Practices (ACIP) to all adult Medicaid beneficiaries as required by the Inflation Reduction Act of 2022.

This amendment proposes to add Preventive Services to cover all vaccines for adults and their administration recommended by the Advisory Committee on Immunization Practices (ACIP).

This amendment is to expand the Oral Health Connections Pilot project until December 31, 2023, modifying the age range for pregnant clients from 21 to 64, to, 16 and older, and changing the age range for diabetic customers from 21 to 64, to, 21 and older. Clients who were qualified for both Medicaid and Medicare (dual eligibles) will also be able to participate.

This amendment updates Nursing Facility provider enrollment and increases Nursing Facility Rates for State Fiscal Year (SFY) 2024.

This amendment is to clarify and update denture policy categorical information and clarify exemptions in the prosthodontics (removable) general policies for Medi-Cal.

This amendment is to allow medically necessary cosmetic procedures for recipients who have been diagnosed with gender dysphoria or gender incongruence.