Medicaid State Plan Amendments

This Alternative Benefit Plan (ABP) amendment complies with Section 11405 of the Inflation Reduction Act (IRA) aligning the new mandatory coverage of Medicaid adult vaccinations for the expansion population under ABP5 benefits.

This amendment is to comply with Section 1940 (42CFR 1396w) of the Social Security Act by contracting with vendors who specialize in automated financial institution verification for Medicaid agencies and check the financial resources of Medicaid applicants/recipients.

This amendment provides reimbursement for services provided by licensed pharmacists, and pharmacy interns and pharmacy technicians supervised by phamacists, who are acting within their scope of practice or in a collaborative agreement with a provider licensed in Virginia or are specified in Board of Pharmacy protocols for licensure that have been reviewed and accepted by the Department of Medical Assistance Services and are services covered by Medicaid.

This SPA proposes to update the professional dispensing fees

CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to add supplemental payments to adult family care services providers and several hospitals.

New Inpatient FFS UPL supplemental payment for qualifying hospitals

This plan amendment updates the Radiology Reimbursement Rates.

This SPA updates the reimbursement methodology for family planning services and supplies, home health services, dental services, and certain rehabilitative services.

This SPA authorizes reimbursement rate increases for primary care, obstetric, and non-specialty mental health services effective for dates of service on or after January 1, 2024.

This plan amendment updates the Residential Pediatric Recovery Centers.