This SPA adds coverage for the eligibility group for adults with income below 133% of the FPL under Section 1902(a)(10)(A)(viii) of the Social Security Act

Updates the dental reimbursement fee schedules

This SPA describes the methodology used by the state for determining the appropriate FMAP rates, including the increased FMAP rates, available under the provisions of the Affordable Care Act applicable for the medical assistance expenditures under the Medicaid program associated with enrollees in the new adult group adopted by the state and described in 42 CFR 435.119.

Proposes reimbursement to hospitals other than critical access hospitals for each day after the tenth (10th) day that an eligible individual is in the care of the hospital while awaiting placement in a nursing facility

This eligibility SPA increases the eligibility thresholds for the state’s Medicare Savings Program eligibility groups effective 2/1/20. This SPA also updates the levels for the Optional State Supplement Beneficiaries group effective 1/1/20

Proposes to update the payment rates for nursing facility residents to provide for reimbursement when a resident of a Disaster Struck Nursing Facility must be temporarily evacuated to another facility due to a disaster for a period of up to thirty (30) days.

The state plan amendment establishes services and a reimbursement methodology for Certified Community Behavioral Health Clinics (CCBHCs) in the state plan. 

Adopt provisions governing medication-assisted opioid use disorder (OUD) treatment in opioid treatment programs, for Medicaid-eligible recipients ages 18 and over, diagnosed with OUD

Removes monthly prescription limit for drugs that require frequent monitoring. In addition, it increase prescription quantity for drugs within the maintenance drug list from 100 dosage units to a 90-day supply per claim

Proposes to allow the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271).