Medicaid State Plan Amendments

This plan amendment adds the Rural emergency Hospital (REH) reimbursement service.

The purpose of this plan amendment is to establish a four percent (4%) rate modifier for certain EPSDT early intervention (EI) services that are provided to children who reside in rural and under served areas of the State.

This plan amendment proposes to add reimbursement for ambulatory non-transport services.

This amendment complies with the mandatory exception to the Medicaid clinic services benefit “four walls” requirement for Indian Health Service (IHS) and Tribal clinics and elects the optional exceptions for behavioral health clinics and clinics located in rural areas.

This plan amendment increases the High Medicaid Volume Safety Net Hospital Supplemental Payment by $20 million for inpatient acute hospital services in rate year 2025.

This plan amendment updates reimbursement for outpatient or professional claims to be allowed if billed by a provider other than the admitting inpatient hospital.

This amendment is to provide for mandatory coverage in accordance with section 1902(a)(84)(D) of the Social Security Act (the Act) for eligible juveniles who are incarcerated in a public institution post-adjudication of charges.

This State Plan Amendment attests to the state's compliance with the third-party liability requirements in Section 1902(a)(25)(1) of the Social Security Act.

This amendment proposed to disregard from countable resources certain Medicare premium refunds.

This plan amendment updates the rates for noninstitutional outpatient services, maternal and child health services, primary care, behavioral health services, and other services and adds a supplemental payment for institutional services for intermediate care facilities.