Medicaid State Plan Amendments

Effective May 1, 2021, this amendment adds greater clarification around Automatic Assignment of Rights. 

Proposes to update payment rates and provider standards for Early Intensive Developmental and Behavioral Intervention (EIDBI) services

CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to temporarily modify the provider recertification process for providers of 1915(i) state plan HCBS. This amendment allows the state to align the state's processes with the state's 1915(c) HCBS and Appendix K submissions.

CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment seeks to modify certain requirements of Title XIX of the Social Security Act to address the COVID-19 public health emergency, in order to increase the reimbursement for COVID-19 vaccine administration per dose.

Effective July 1, 2017, this amendment adjusts the Alternative Benefit Plan (ABP) to add nonmedical transportation (NMT) services as a covered ABP benefit to all eligible Medi-Cal beneficiaries to align with the addition of NMT services as a covered benefit.

Effective January 1, 2021, this amendment updates the DSH program as well as inpatient hospital payments. Specifically, this (1) Updates the base year used to calculate the interim DSH payments and update the inflation rate used to trend the DSH base year cost; (2) expend 100% of its FFY 2021 allotment; (3) discontinue the normalization adjustment to the hospital specific DSH limits; (4) update the inflation rate used to trend the DSH base year cost to the end of the 2019 calendar year; (5) create separate DSH pools from the existing 2021 DSH allotment to be spread among rural hospitals. Additionally, South Carolina will (1) update the swing bed and administrative day rates based on the October 1, 2020 Nursing Facility Payment rate update; (2) update the long term per diem psychiatric hospital rates based on the FY2019 cost reporting period trended forward to the payment period; (3) provide for 100% retrospective cost settlement for all IP and OP services in rural hospitals.

Effective July 1, 2021, this amendment revises inpatient payment methodology for Medical and Remedial Care and Services. Specifically, this revision to methodology includes incorporating enhanced Base Rates for inpatient claims reimbursement, Graduate Medical Education (GME) payment methodology, and Disproportionate Share Hospital (DSH) payments.

Effective October 1, 2020 until September 30, 2025; pursuant to 1905(a)(29) of the Social Security Act and Section 1006(b) of the SUPPORT Act, this amendment adds medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan.

This amendment proposes to add medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan.

This state plan amendment amends the reimbursement methodology for federally qualified health centers (FQHC) to separate reimbursement for long-acting reversible contraceptive (LARC) devices from the encounter rate.