Medicaid State Plan Amendments

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.

The purpose of this State Plan Amendment is to make provisions governing Indian Health Services (IHS) in order to implement a mandatory exception to the Medicaid clinic services “four walls” requirement for IHS and Tribal clinics.

This amendment complies with the mandatory exception to the Medicaid clinic services benefit "four walls" requirement for Indian
Health Services (IHS) and Tribal clinics.

This SPA adds an exception to the four walls requirement for clinic services provided by Indian Health Service (IHS) or Tribal facilities.

This amendment meets the requirements of Section 5121 of the Consolidated Appropriations Act, 2023 (CAA, 2023), which requires the provision of medically necessary EPSDT screening and diagnostic services.

This amendment adds Certified Wellness Coach Services as a new benefit.

This amendment updates Attachments 3.1-A and 3.1-B of the Medicaid State Plan to comply with CMS' final rule amending 42 CFR 440.90 and authorizing an exception to the Medicaid clinic services "four walls" requirement for Indian Health Services (IHS) and Tribal clinics.

This state plan amendment (SPA) updates Attachments 3.1-A and 3.1-B of the Medicaid State Plan to comply with CMS' final rule amending 42 CFR 440.90.

This SPA allows Kentucky to enter into Value-Based Supplemental Rebate Agreements with drug manufacturers on a voluntary basis.

This amendment proposes to request an extension of the exception to the requirement of having a Recovery Audit Contractor (RAC) for an additional two (2) years, through May 31, 2027.