Medicaid State Plan Amendments

This SPA is to memorialize the new income standards for its optional state supplement program, the beneficiaries of which are eligible for Medicaid under Alaska's state plan, and make related changes to other eligibility groups covered under its state plan.

This plan amendment proposes to allow the state to individually negotiate reimbursement rates for EPSDT providers when it is demonstrated that the in-state payment methodology insufficiently accounts for the level of acuity, effective July 1, 2024.

This plan amendment updates the Financial Management Services Agencies (FMSAs) fee schedule, effective October 1, 2024.

This amendment is to increase its medically needy income levels.

This amendment proposes to update language regarding behavioral analysis services to clarify eligible providers and excluded procedures.

This amendment is to update State Plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.

This plan amendment increases per diem payment for services provided to ventilator-dependent Medicaid beneficiaries residing in a ventilator-dependent wing of a contracting South Carolina Medicaid nursing facility to a total per diem rate of $708 per member, per day.

This plan amendment increases the Arizona Health Care Cost Containment System (AHCCCS) Fee for Service Nursing Facility Per Diem Rates.

This plan amendment establishes a new class of supplemental payments to qualifying Medical Assistance (MA) enrolled acute care general hospitals that have a negative operating margin, high MA share of net patient revenue (NPR), low commercial NPR, and are in an area of the Commonwealth with a disproportionate need for MA services.

This plan amendment adds language to clarify when hospital transfers qualify for outlier payments and includes a detailed list of applicable discharge status codes that determine payment eligibility.