Medicaid State Plan Amendments

This amendment will allow the District to provide assurance of compliance with mandatory annual state reporting of the My DC Health Home's Core Set of Children's Health Care Quality Measures and the behavioral health measures on the Core Set of Adult Health Care Quality Measures for Medicaid.

This SPA amends the State Plan to update reimbursement methodology for Long-Acting Reversible Contraceptives (LARCs) and make required changes to the payment methodology for hospice services.

This SPA amends the State Plan to authorize coverage of drugs authorized for import by the Food and Drug Administration when medically necessary during drug shortages.

This SPA amends State Health Home Program to comply with new federal requirements for mandatory Health Home Core Set(s) reporting.

This SPA provides assurance in Attachment D that the benefit package provided for all individuals through the postpartum extension complies with section 1937 of the Act, including the provision of essential health benefits (EHBs) and that no treatment limitations that are more restrictive than the Alternative Benefit Plan (ABP).

This SPA adds payment for new Collaborative Care Model services under the Physician and Other Licensed Practitioner benefits.

This amendment is to terminate the WV Health Homes program statewide.

This amendment is to update assurances in accordance with all requirements in 42 CFR §§ 437.10 and 437.15.

This amendment is to update assurances in accordance with all requirements in 42 CFR §§ 437.10 and 437.15.

The proposed amendment updates the Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program fee schedule, effective September 1, 2024.