Medicaid State Plan Amendments

To raise the Federal Poverty Level (FPL) for Qualified Medicare Beneficiaries from 100 percent to 138 percent and the Qualified Individual's eligibility level to greater than 138 percent FPL to 186 percent FPL.

This SPA is to amend the provisions governing Targeted Case Management under the New Opportunities Waiver (NOW) and Early and Periodic Screening, Diagnostic and Treatment (EPSDT) programs, in order to allow two quarterly virtual visits that are not the initial visit or the annual plan of care visit.

This amendment expands coverage for point of care drug testing to outpatient substance abuse and substance abuse day treatment benefits.

This plan amendment increases the base rate for General Hospitals and Centers of Excellence.

This plan amendment updates the provisions of the emergency transportation payment for program 2024.

This amendment updates the fee schedules listed on the Introduction Pages.

This amendment is to allow Rural Health Clinics in Nebraska to bill and be reimbursed at their encounter rate for qualifying services provided via telehealth.

This amendment is to waive the requirement to implement a Recover Audit Contractor (RAC) for two years.

Adds psychiatric residential treatment facility (PRTF) se1vices to Ohio's Alternative Benefit Plan to align with the Medicaid State Plan.

To add coverage and payment provisions for Psychiatric Residential Treatment Facility services to the Medicaid State Plan to meet the needs for Ohio's youth.