Medicaid State Plan Amendments

The proposed amendment updates the payment rate for the Pediatric Care Facility Special Reimbursement Class of Nursing Facilities.

The purpose of the amendment is to update the rate methodology and payment rates for Intermediate Care Facilities (ICF) in support of increasing the base wage for certain personal attendants under Medicaid and other programs administered by HHSC to $10.60 per hour.

The purpose of the amendment is to update the rate methodology and payment rates for Nursing Facilities (NF).

The amendment makes changes to inpatient hospital rates.

IGA GME program

This SPA proposes to increase the professional dispensing fee based on prescription volume.

This SPA, removes the Medication Therapy Management (MTM) specific section to avoid duplicated language within this section.

This SPA updates the effective date of the transportation services fee schedule.

This SPA updated rates and billing codes in alignment with the coding and coverage changes from the Centers for Medicare and Medicaid Services (CMS), the state, and other sources.

The proposed amendment updates the rate methodology and payment rates for Primary Home Care (PHC) and Community Attendant Services (CAS) to support base wage increases for certain personal attendants. The proposed amendment also revises the initial cost report database to calculate the direct care cost component to be the most recent PHC Medicaid cost report database.