Medicaid State Plan Amendments

2022 Voluntary Outpatient UPL Payments.

This amendment proposed to elect use of the Federal Poverty Level in determining income eligibility under Puerto Rico's State Plan. 

This amendment, the state is expanding the needs-based criteria for children under five, adds Participant-Directed Services and related budget authority, and adds incentive payments to providers who assist individuals with obtaining competitive and integrated employment.

This plan amendment updates the effective date for the 1915(i) Community Transition Services, Targeted Case Management.

The SPA allows doctoral level psychology interns under the supervision of a licensed psychologist to provide services for MO HealthNet participants.

This amendment proposes to provide coverage of all approved vaccines recommended by the Advisory Committee on Immunization Practices and vaccine administration when furnished by a qualified provider.

This amendment proposes to update the preventive services to align with the United States Preventive Services Task Force recommendations for preventive screening services and the Advisory Committee on Immunization Practices recommendations for immunizations.  Additionally, this amendment proposes to include the current reimbursement methodology for vaccines for both children and adults under the Preventive Services section of the State Plan. This amendment also proposes to remove the limits previously applied to the ambulatory care annual visits.

This Amendment Migrated_HH.IA-16-012 - Chronic Conditions Health Home - Managed Care Implementation to end the Health Home Program as part of their transition plan

The SPA proposes to move South Dakota Medicaid from the Resource Utilization Group Ill (RUG Ill) reimbursement model to the Patient Driven Payment Model (PDPM) reimbursement model for Nursing Facility services.

This amendment adopts version 40 of the APR-DRG grouper, which updates the relative weight values, and average national length of stay (ALOS).