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LA-24-0015

This plan amendment edits the provisions governing reimbursement for hospice services in order to
ensure that the current payment methodology aligns with CMS requirements.

WI_Fee_HCBS2_Renewal_20240101-20241231

Submitted by rajesh.kolli@t… on
File - Approval Letter Media
WI_Fee_HCBS2_Renewal_20240101-20241231
Approval Date
Effective Date
State
Wisconsin
Payment Type
Fee schedule
Provider Class
HCBS/personal care services
Review Type
Renewal
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

CO-24-0015

This SPA adds coverage of select prescribed drugs that are not covered outpatient drugs, and also adds coverage of prescribed drugs that are not covered outpatient drugs in cases of a drug shortage.

WA_Fee_IPH.OPH2_New_20240101-20241231

Submitted by rajesh.kolli@t… on
File - Approval Letter Media
WA_Fee_IPH.OPH2_New_20240101-20241231
Approval Date
Effective Date
State
Washington
Payment Type
Fee schedule
Provider Class
Inpatient hospital service
Outpatient hospital service
Review Type
New
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

OH_VBP.Fee_AMC.PC.SP.Oth_Amend_20240101-20241231

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File - Approval Letter Media
OH_VBP_Fee_AMC.PC.SP.Oth_Amend_20240101-20241231
Approval Date
Effective Date
State
Ohio
Payment Type
Fee schedule
Value-based payment
Provider Class
Other
Primary care services
Professional services at an academic medical center
Specialty physician services
Review Type
Amendment
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

NY_Fee_PC_New_20240401-20250331

Submitted by rajesh.kolli@t… on
File - Approval Letter Media
NY_Fee_PC_New_20240401-20250331
Approval Date
Effective Date
State
New York
Payment Type
Fee schedule
Provider Class
Primary care services
Review Type
New
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

MS_Fee.VBP_IPH.OPH_Renewal_20240701-20250630

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File - Approval Letter Media
MS_Fee.VBP_IPH.OPH_Renewal_20240701-20250630
Approval Date
Effective Date
State
Mississippi
Payment Type
Fee schedule
Value-based payment
Provider Class
Inpatient hospital service
Outpatient hospital service
Review Type
Renewal
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

MI_Fee_BHO_New_20231001-20240930

Submitted by rajesh.kolli@t… on
File - Approval Letter Media
MI_Fee_BHO_New_20231001-20240930
Approval Date
Effective Date
State
Michigan
Payment Type
Fee schedule
Provider Class
Behavioral health outpatient services
Review Type
New
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

FL_Fee_PC.SP2_Renewal_20231001-20240930

Submitted by rajesh.kolli@t… on
File - Approval Letter Media
FL_Fee_PC.SP2_Renewal_20231001-20240930
Approval Date
Effective Date
State
Florida
Payment Type
Fee schedule
Provider Class
Primary care services
Specialty physician services
Review Type
Renewal
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date
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