Medicaid State Plan Amendments

This amendment is to provide 12 months of continuous eligibility (CE) for children under the age of 19 in Medicaid.

This amendment is to amend its hospital presumptive eligibility SPA and presumptive eligibility program to include a performance standard for qualified entities or hospitals determining presumptive eligibility for pregnant women and/or children.

This SPA adds coverage of developmental disabilities health homes services to the Alternative Benefit Plan.

This plan amendment updates Medicaid reimbursement rates for physical therapy, occupational therapy, and speech-language therapy services under the home health benefit.

This plan amendment implements the tri-annual outpatient hospital rate rebase.

This plan amendment updates the family planning services fee schedules.

This amendment is to add palliative care services in non-hospital settings.

This amendment establishes a Coordinating, Aligned, Relationship-centered, Enhanced Support (CARES) Targeted Case Management (TCM) benefit for children.  This new CARES TCM will provide intensive support in care planning and coordination of services for eligible medically complex MassHealth members younger than 21.

This SPA proposes to suspend the Medicaid Recovery Audit Contractor Program, a requirement in section 1902(a)(42)(B)(i) of the Social Security Act, for a two-year period because ninety-seven percent of Medicaid beneficiaries participate in managed care.

This SPA provides Nevada with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.