Medicaid State Plan Amendments

Effective 11/01/2019 this amendment clarifies that substance use disorder (SUD) early intervention services provided by a SUD agency are covered and SUD treatment services may be provided in an institution for mental disease (IMD).

Updates the payment methodology for hospice services to align with CMS’ Medicaid hospice reimbursement requirements.

updates the payment methodology for ambulance services

CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to add pharmacists, pharmacy technicians, pharmacy interns and pharmacies as qualified providers for COVID-19 vaccine administration. It also establishes reimbursement of swing beds in Critical Access Hospitals at a rate of $400/day and adopts the Medicare fee schedule for COVID-19 vaccine administration reimbursement.

CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to increase the payment rates for the administration of COVID-19 vaccines to the Medicare rate in effect at the time the service was provided, without any geographic adjustment.

CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to reimburse for the COVID-19 vaccine administration during the COVID-19 Public Health Emergency (PHE) at 100% of the corresponding Medicare reimbursement rate at the time the service is provided. For any COVID-19 vaccine administration by a Tribal 638 non-FQHC clinic provider that would not otherwise have qualified for an All Inclusive Rate (AIR) payment, the COVID-19 vaccine administration will be reimbursed based on the fee schedule rates established in this SPA. The SPA also clarifies that pharmacies are qualified providers of COVID-19 vaccinations per the HHS COVID-19 PREP Act Declaration and authorizations and that pharmacy technicians and pharmacy interns acting within their scope of practice may administer the COVID-19 vaccination under the supervision of an immunizing pharmacist. This SPA also applies the newly added benefit to the Alternative Benefit Plan (ABP) population.

CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. reimburse 100% of Medicare for COVID laboratory testing and COVID laboratory specimen collection.

CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to authorize administration of COVID-19 vaccines with a FDA Emergency Use Authorization (EUA) status, without regard to the state's limitation on coverage of experimental procedures or services. This SPA also authorizes COVID drug treatments that may be provided under EUA without regard to rebate status.

CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to allow flexibility in the setting where autism treatment services are provided and face-to-face requirement during service provision.

CMS is approving this time-limited state plan amendment to
respond to the COVID-19 national emergency. The purpose of this amendment is to increase certain payment rates and to allow additional providers the ability to order Home Health services including Durable Medical Equipment.