Medicaid State Plan Amendments

This amendment assures coverage for clinic services outside of the "four walls" of Indian Health Service (IHS)/ Tribal clinics.

This plan amendment amends the provisions governing reimbursement methodology for intermediate care facilities for individuals with intellectual disabilities (ICF/IID) in order to provide for a one-time lump sum payment in fiscal year 2025, to all privately owned or operated ICF/IID that billed Medicaid between August 1, 2024 and October 31, 2024, and are active and Medicaid certified at the time of payment.

This plan amendment updates long-acting reversible contraceptive devices provided immediately postpartum at an acute care hospital which are exempt from the DRG payment method and are reimbursed via the fee schedule.

This amendment makes requirements for physical therapy services consistent with requirements for Medicaid home health
services.

This amendment proposes to assure coverage for clinic services outside of the “four walls” of behavioral health clinics or clinics located in rural areas.

This amendment updates Attachments 3.1-A, 3.1-B, and 4.19-B pages of the Medicaid State Plan to comply with federal regulation 42 CFR 440.169 and establishes a new target case management benefit for children in Tennessee who are receiving early intervention services.

This plan amendment updates Rhode Island’s Medicaid State Plan to reflect changes in payment rates for lead investigations and physical therapies and related services.

This plan amendment updates reimbursement rates for LARC/ventilator/brain injury care inpatient payments which are paid outside the DRG.

The proposed amendment updates the Physicians and Other Licensed Practitioners' Services fee schedules, effective March 1, 2025.

This amendment will eliminate the “four walls” limitation for Indian Health Services-Memorandum of Agreement providers and makes a technical change to the title of psychological assistant to psychological associate, to align with recent state law changes.