Medicaid State Plan Amendments

This plan amendment updates rates for nursing facilities based on the most recent cost report data available (i.e., fiscal year ending Sept. 30, 2023); applies a 1.8% inflation factor in the calculation of the October 1, 2024, payment rates; maintains the previously approved cost center standards determining general services standards at 110% of the mean, and determining laundry, housekeeping, and maintenance standards at 105% of the mean; maintains the minimum occupancy used for Medicaid rate setting purposes at 85%; and increases the square footage allowance used for capital cost reimbursement purposes from $276.71 to $283.25

This plan amendment updates the list of government-operated hospitals subject to specified reimbursement methodologies for inpatient hospital services.

This plan amendment updates California's All Patient Refined Diagnosis Related Group (APR-DRG) payment parameters for state fiscal year 2024-2025.

This amendment is to add Certified Behavioral Health Support Specialists (BHSS) as Medicaid providers to the Medicaid State Plan.

This amendment proposes to eliminate cost sharing for all Medicaid recipients and services.

This plan amendment increases the base rate for standard nursing facilities, nursing facilities serving patients with Acquired Immune Deficiency Syndrome (AIDS), and standard private and specialized private intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs).

This SPA removes specifics for identifying claims for covered outpatient drugs purchased through the 340B Program, as industry standards may periodically change.

This plan amendment renews and modifies the reimbursement rate methodology for Freestanding Skilled Nursing/Subacute Facilities Level-B, by authorizing aggregate increases to the weighted average Medi-Cal reimbursement rate components for labor and non-labor costs and authorizing a new Workforce Standards Program rate augmentation.

This plan amendment updates the list of government-operated hospitals subject to specified reimbursement methodologies for inpatient hospital services.

This amendment is a state plan coverage for supportive living services.