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

The Centers for Medicare & Medicaid Services (CMS) granted an initial approval to the State of Massachusetts for multiple section 1135 flexibilities on March 26, 2020.  Your follow-up communication to CMS on April 23, 2020 detailed a number of additional federal requirements that also pose issues or challenges for the health care delivery system in Massachusetts and requested a waiver or modification of those additional requirements.

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NM-20-0008

This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to implement targeted access supplemental payments for Safety-Net Care Pool (SNCP) hospitals.

AL-20-0009

This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow code D1999 (Unspecified preventive procedure) to be billed and reimbursed at $20.00 to allow for reimbursement of PPE and cleaning supplies PPE that are necessary for dental offices to provide treatment to recipients.

FL-20-0001

Applies an income disregard for the eligibility determination process for individuals with disabilities with earned income through paid employment.

CT-20-0013

Increases the rate for Liletta, a Long-Acting Reversible Contraceptive device (LARC), code J7297 (Liletta, 52 mg) to $100 on the Family Planning Clinic fee schedule, which is necessary to reimburse providers for the device’s increased acquisition cost. This SPA also removes code 90461 - Immunization administration from the Medical Clinic fee schedule to ensure accurate billing based on national definitions.