Technical changes to the Child Mental Health Wraparound HCBS state plan benefit to correct errors in pagination resulting from the approved SPA TN 19-007. This SPA makes revisions to the qualification requirements for staff making level of need determinations to allow for the inclusion of experience in areas closely related to wraparound services to count towards an individual’s experience, in addition to clinical experience.

Proposes a $60 increase to the LTAC base per diem rate

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)

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).

This Pa SPA continues the funding of multiple classes of  inpatient  DSH payments and supplemental payments to Medical Assistance-enrolled, qualifying inpatient acute care general hospitals for State Fiscal Years 2019-2020.

This State Plan Amendment proposes to revise the rate setting methodology for NYS Office of Alcoholism and Substance Abuse Services (OASAS) freestanding Medically Supervised Inpatient Withdrawal (MSIW) programs. The program will move to site-specific per-diem fees, which are inclusive of capital costs, based on a regression model that uses normalized cost per bed in comparison to service volume. Fees will be assigned to each facility based on its base year service volume (as a proxy for bed size) and a regional cost factor. The fees for each bed size are detailed in the SPA. 

Amends the North Dakota State Plan regarding the payment methodology for Tribal 638 facilities that elect to enroll as a Federally Qualified Health Center. 

This SPA is to comply 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). State is claiming -0- fiscal impact for 2020 and 2021. 

This SPA continues funding of DSH payments to qualifying MA-enrolled acute care general hospitals that provide a high volume of inpatient services to MA eligible and low income populations. These payments are intended to promote access to medically necessary inpatient services for MA eligible persons. The DHS published notice of its intent to allocate funding for these payments in the Pennsylvania Bulletin on December 21, 2019, at 49 Pa.B. 7541. 

This SPA authorizes the DHS to continue to make county nursing facility safety net payments to qualifying county nursing facilities in Fiscal Year (FY) 2019-2020. The DHS published a public notice in the Pennsylvania Bulletin on January 11, 2020.  To qualify for a safety net payment, the facility must be a county nursing facility both during the period for which the payment is being made and at the time the payment is made.