Medicaid State Plan Amendments

This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to approve certain interim payments to hospitals, to make technical corrections to a previously-approved benefit adjustment, and to clarify the effective date for the previously-approved new optional eligibility group.

This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to adopt the following less restrictive income methodologies: Disregard from income, any payment made by a state, local or tribal government to relieve the adverse economic impacts of the COVID-19 pandemic for certain eligibility groups, and Disregard from assets the payments of a state, local or tribal government to relieve the adverse economic impacts of the COVID-19 pandemic that are retained following the month of receipt during the disaster period, and/or retained following the disaster period for certain eligibility groups.

This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing and to allow hospitals to make presumptive eligibility determinations for this population.

This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to increase base payments to nursing homes

This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to extend the reasonable opportunity period for certain non-citizens, allow hospital presumptive eligibility (PE) for additional groups and designates the State Medicaid Agency as a qualified entity for PE for MAGI groups, suspend all cost-sharing, modify the NF benefit to include health care isolation centers (HCIC) to provide COVID-related care for individuals who cannot safely remain at home or in a NF. It also suspends limits on private duty nursing services; allows physicians and other licensed practitioners, in accordance with state law, to order durable medical equipment; expands telehealth; and extends prior authorization for medications by automatic renewal without clinical review or time/quantity extensions. It also makes the following Payment changes: adds a telehealth originating site fee; increases payments for lab and NF services related to COVID; and increases limits on bed hold days. Finally, t designates COVID-19 quarantine or isolation levels of care as categorical qualification for pre-admission screening; and suspends state plan staffing requirements for NF ventilator weaning.

Revises the Medical Clinic, Family Planning Clinic, Behavioral Health Clinic, Rehabilitation Clinic, and Ambulatory Surgical Center fee schedules

Incorporates various 2020 Healthcare Common Procedure Coding System (HCPCS) updates (additions, deletions and description changes) to the Physician Office & Outpatient, Physician-Radiology, Physician-Surgery, and Psychology fee schedules. In addition, there are updates to the reimbursement methodology for specified drugs in order to comply with the approved Medicaid State Plan methodology for physician-administered drugs

Adds income and resource disregards to certain individuals eligible for home and community-based waiver services under Section 1915c of the Social Security Act..

This amendment is to update the needs-based criteria; update who can perform evaluations and re-evaluations of 1915(i) eligibility; update language related to the CMS HCBS settings requirements; update who can perform the person-centered planning assessment; revise services covered under Habilitation services; and update reimbursement pages.

Proposes to authorize the state to transfer all of the drugs on the Prescriber Attestation List to the Automatic Exemption List