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Section 1135 Waiver Flexibilities - Montana Coronavirus Disease 2019 (Third Request)

The Centers for Medicare & Medicaid Services (CMS) granted an initial approval to the State of Montana for multiple section 1135 flexibilities on March 30, 2020.  Your follow-up communication to CMS on November 2, 2020 detailed a number of additional federal requirements that also pose issues or challenges for the health care delivery system in Montana and requested a waiver or modification of those additional requirements.

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NM-20-0014

CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to increase the dispensing fee for curbside pharmacy services.

NM-20-0013

CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to increase reimbursement to non-hospital providers.

MS-20-0005

allow the state to revise the Medicare fee schedule update frequency from quarterly to annually. It also proposes to reimburse physician-administered drugs at Wholesale Acquisition Cost (WAC) +0% if there is no Medicare Part B Drug Fee Schedule or Medicare Addendum B OPPS Fee Schedule rate available.

MO-20-0018

Updates the provider fee schedule to add a modifier for individual, family, and group psychotherapy procedure codes to pay an enhanced rate for providers certified in specific evidence-based practices that provide evidence-based treatment to individuals under 21 years of age who have experienced severe physical, sexual, or emotional trauma as a result of abuse or neglect.

NE-20-0003

adds the Medically Monitored Withdrawal service including initial assessment, substance use disorder assessment, medication administration, and individual, group, and family counseling services. The provider qualification descriptions have also been added.

Section 1135 Waiver Flexibilities - Minnesota Coronavirus Disease 2019 (Second Request)

The Centers for Medicare & Medicaid Services (CMS) granted an initial approval to the State of Minnesota for multiple section 1135 flexibilities on March 27, 2020. Your follow-up communication to CMS dated October 27, 2020, includes a request for an additional flexibility we can now approve. Attached, please find a response to your request for waivers or modifications, pursuant to section 1135 of the Social Security Act (Act), to address the challenges posed by COVID-19.

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IN-20-0015

Updates the Medicaid reimbursement rates for medical equipment (ME) and medical supplies HCPCS codes subject to the requirements of the 21st Century Cures Act of 2016. 
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