Medicaid State Plan Amendments

This plan amendment removes duplicative language under the school-based services section of the state plan.

This SPA updates the payment methodology for licensed pharmacist services to align with physician payment for the testing, prevention, or treatment of human immunodeficiency virus (HIV) or hepatitis C.

This plan amendment updates the Disproportionate Share Hospital (DSH) program reimbursement methodology and revises the DSH allotment distributed among eligible hospitals.

This plan amendment updates the plan by removing Medicare and other third party (non-Medicaid) ancillary costs from the allowable Medicaid reimbursement for Class I nursing facilities.

This plan amendment updates the plan by revising the Pay-For-Performance Supplemental Medicaid payment methodology to Class 1 nursing facilities from a per-diem add-on dollar amount to a flat per-diem multiplier methodology.

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

This SPA adds coverage of select prescribed drugs that are not covered outpatient drugs, and also adds coverage of prescribed drugs that are not covered outpatient drugs in cases of a drug shortage.

This plan amendment edits the provisions governing reimbursement for hospice services in order to
ensure that the current payment methodology aligns with CMS requirements.

This plan amendment authorizes the Department to increase the funding for supplemental payments to qualifying acute care general hospitals.

This plan amendment will permit the District of Columbia Medicaid program to reimburse public specialty inpatient hospitals at a rate that is fair and reasonable.