Medicaid State Plan Amendments

This SPA changes the MO HealthNet Dental Program to allow eligible MO HealthNet participants aged 21 and older to receive periodic oral evaluations. The SPA also allows MO HealthNet-enrolled dental providers to provide and receive reimbursement for the evaluations rendered.

Changes to the early and periodic screening, diagnostic and treatment benefits, and related payment methodologies. The proposed changes will more accurately align payments for direct medical services, which are outlined in an individualized education plan and supplied in a school-based setting, to actual costs for providing these services in a school setting.

This plan amendment will pay a $12 direct care add‐on to private (non-state) owned intermediate care facilities for individuals with intellectual disabilities (ICF/IID) for increased costs related to retaining and hiring direct care staff.

This plan amendment updates COLA (Cost-of-Living Adjustment) Increase.

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.