Medicaid State Plan Amendments

With this amendment, the state is expanding 1915(i) eligibility to youth with a history of foster care and probation
involvement.

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 amendment reimburses of Section 5121 of the Consolidated Appropriations Act, 2023 (CAA, 2023), to add Targeted Case Management services to eligible juveniles.

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.

This plan amendment enables Indian Health Services (IHS) facilities, to bill MassHealth for up to five medically necessary visits per person per day at the all-inclusive (AIR) IHS encounter rate.

This plan amendment reallocates the quality improvement incentive (QII) pool amounts for nursing facilities (NF) and intermediate care facilities for individuals with intellectual disabilities (ICF/IID).

This plan amendment increases rates for Personal Care Attendants (PCA) who have completed the new hire orientation.

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.

This amendment adds an exception to the four walls requirement for clinic services provided by Indian Health Service (IHS) or Tribal facilities, for clinics located in rural areas, and for clinic services delivered to an eligible individual who does not reside in a permanent dwelling or does not have a fixed home or mailing address.