Medicaid State Plan Amendments

This plan amendment implements a one percent (1%) Cost-of-Living Adjustment (COLA) to Specialty Hospital rates.

This plan amendment updates Fee-for Service rate schedules for Physicians and Other Licensed Practitioner services.

This amendment proposed income disregards for the Qualified Medicare Beneficiary (QMB) and Qualifying Individual (QI) eligibility groups.

The Centers for Medicare & Medicaid Services (CMS) has reviewed the proposed Illinois state plan amendment (SPA) to Attachment 4.19-D IL-23-0027, which proposes increases to the reimbursement rate for facilities by the Department of Public Health under the ID/DD Community Care Act as an ID/IDD facility and medically complex for the developmentally disabled facilities licensed under the MC/DD Act.

The Centers for Medicare & Medicaid Services (CMS) has reviewed the proposed Illinois state plan amendment (SPA) to Attachment 4.19-D IL-23-0033, which proposes to increase by 12% the support component of the nursing facility rate for facilities licensed under the Nursing Home Care Act as skilled or intermediate care facilities.

This SPA establishes an emergency interim payment methodology for certain providers affected by the Change Healthcare cybersecurity incident.

This plan amendment updates the Disproportionate Share Hospital payment time period to the current fiscal year, the fiscal year amount, and the payment frequency.

The Centers for Medicare & Medicaid Services (CMS) has reviewed the proposed Wisconsin state plan amendment (SPA) to Attachment 4.19-A and B WI-24-0001, which was submitted to CMS on March 29, 2024. This plan amendment updates the Inpatient and Outpatient Hospital State Plans to increase the statewide Medicaid fee-for-service base rates for inpatient and outpatient services paid under the DRG and EAPG systems above and beyond the annual inflation increase.

With this amendment, the state will permanently adopt COVID-19 PHE flexibilities; and add Remote Supports & Host Home Service modalities to align with the state's 1915(c) HCBS waivers.

To update reimbursement methodology for Rehabilitation Day Services and Psychosocial Rehabilitation (Clubhouse) Services. To add screening, as a new service under the Mental Health Rehabilitative Services benefit. To rename Community Based Intervention Level 1, Multisystemic Therapy. To add a new service, Attachment and Biobehavioral Catchup, as a preventive service. To update the structure of Methadone Services in Opioid Treatment Programs.