Medicaid State Plan Amendments

This amendment updates the State's Alternative Benefit Plan (ABP) to add managed care organizations (MCO) and prepaid ambulatory health plans (P AHP) for expansion adults.

This amendment expands Peer Support Services, which allows providers outside of the Community Mental Health Center (CMHC) network to employ Peer Support providers and to be reimbursed for providing Peer Support Services.

This amendment (1) allows Indiana Medicaid to reimburse for medically necessary nursing services in school-based services pursuant to a Medicaid enrolled student's educational program or plan as required by the Individuals with Disabilities Education Act (IDEA) or Section 504 of the federal Rehabilitation Act of 1973. 29 U.S.C. 794 and (2) includes coverage for school psychologist testing services if done by a licensed individual and school-based transportation for children under IDEA.

The purpose of the amendment is to update the rate methodology and payment rates for Prescribed Pediatric Extended Care Centers (PPECC).

Primarily updates the rate methodology and payment rate for STAR Kids Community First Choice (CFC) Habilitation and Attendant Care, under the Consumer Directed Services (CDS) option. Other non-substantive edits are provided for clarity.

This amendment provides assurance for compliance with third party liability requirements outlined in the Consolidated Appropriates Act (CAA) of 2022

The SPA exempts structured family caregiver payments as countable income in determining income eligibility for most non-MAGI based eligibility groups.

This SPA proposes to update the reimbursement methodology for physician administered drugs (PAD).

This SPA has been submitted to allow the state to enter outcome-based agreements with manufactures on a voluntary basis.

To reflect a four percent (4.0%) cost of living adjustment for Care Coordination Organization/Health Homes rates for individuals with intellectual and developmental disabilities.