Medicaid State Plan Amendments

This SPA elects the Individuals Eligible for Family Planning Services (“Family Planning”) eligibility group and elect to add Presumptive Eligibility (PE) for the Family Planning eligibility group.

This amendment proposes to exempt children with non-Title IV-E adoption assistance under age 21 and individuals under age 21 with an income above 133% of the federal poverty level from the PCCM program.

Cover adult vaccine administration in accordance with Advisory Committee on Immunization Practices (ACIP) recommendations, in compliance with guidance on mandatory vaccine coverage and administration for adults in alignment with ACIP.

The amendment documents coverage of COVID-19 vaccines and administration of the vaccines for children under the age of 21.

This SPA provides Alaska with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program and increases the income eligibility for pregnant individuals up to 225 percent of the FPL.

This amendment complies with the federal requirement that the state implement a tracking system that ensures that cost sharing and premiums of a Medicaid beneficiary will not exceed five percent of the family income.

This amendment covers for services provided by a licensed recreational therapist.

This amendment adds the Management of Self-Monitoring Blood Pressure (SMBP) treatment plans as a preventive outpatient service for persons using SMBP devices as part of their care.

This amendment provides attestations for preventive services under the Inflation Reduction Act including any covered clinical preventive services with a rating of A or B by the United States Preventive Services Task Force (USPSTF), and adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP), and their administrative costs, without cost sharing to the enrollee.

This amendment will allow Medicaid to exempt anti-retroviral medications used to treat HIV for the purpose of reducing viral load from Medicaid co-payments.  These medications currently require a co-payment of $4 per prescription.