Medicaid State Plan Amendments

This amendment allows the District to update the state’s excluded drug listing; to provide coverage for select agents for the treatment of infertility; to enter in Outcome-based arrangements with manufacturers; and to increase flexibility to improve access to prescription and over-the-counter drugs.

This amendment establishes a primary care case management program (PCCM) for pregnant individuals.

This SPA updates the service unit limit from 240 to 360 per client for targeted case management-transition coordination, adds eligible individuals that reside in a hospital, adds eligible individuals that are at-risk of institutionalization, and changes the name of the service from Transition Services to Transition Coordination Services.

This amendment allows Georgia to enter into value-based and outcome-based contracts.

This amendment will replace instances of the term "Naloxone" with the broader term "opioid overdose reversal agent" as newer products of the class become available.

CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency.  The purpose of this amendment is to extend the Workforce Stabilization Incentive Program through March 31, 2025.

Disproportionate Share Hospitals

Rates and DSH for existing (Terence Cardinal Cooke) and newly certified specialty hospitals.

To update the State Plan as Tribal Nursing Facilities receive a Tribal 638 authority designation to be reimbursed at the OMB publishing rate.

This SPA is to align with dental plan changes made to the state plan, eliminate the $750-per-year adult dental benefit limit, to allow public health licensed dental hygienists to provide certain dental services, and to better align language in the State Plan with state regulations in 471 NAC 6.