Medicaid State Plan Amendments

This plan amendment increases inpatient hospital reimbursement rates effective September 1, 2024.

This plan amendment provides authority to assess a late-file penalty to nursing facilities who do not submit a complete and acceptable cost report within the timeframes established by MDHHS.

This plan amendment updates the Outpatient Hospital reimbursement rates.

This plan amendment increases the rates for the 1915(i) HCBS habilitation services.
 

This plan amendment provides additional payments to non-state government public residential health care facilities.

This plan amendment updates the per diem rates for non-publicly owned hospitals will be increased and payment for services provided under the Substance Using Pregnant People program is an exception to the per diem rate determination for specialty services.

To establish Medical Assistance coverage and rates of payment for Coordinated Specialty Care (CSC), an evidence-based practice model for the treatment of young people experiencing a first episode of psychosis (FEP).

This amendment confirms third-party payer responsibilities in accordance with the Consolidated Appropriations Act of 2022.

This plan amendment updates the rate year 2024 reimbursement for inpatient acute psychiatric hospital services. Specifically, it establishes reimbursement for certain long acting injectable antipsychotic pharmaceuticals covered by MassHealth in addition to the psychiatric per diem rate; and makes technical edits to the Adjudicated Payment Amount Per Discharge (APAD) payment methodology for certain pediatric discharges.

This plan amendment updates the rate year 2024 reimbursement for privately-owned inpatient psychiatric hospital services. Specifically, it establishes a reimbursement methodology for certain long-acting injectable (LAI) antipsychotic pharmaceuticals covered by MassHealth in addition to the psychiatric per diem rate.