The purpose of this plan amendment is to update the reimbursement rates for tuberculosis (TB) clinics within the physician fee schedule and removes the reimbursement pages far TB clinics because they will be paid under the physician fee schedule.

The proposed amendment updates the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) fee schedule.

The purpose of this plan amendment is to remove the eligibility requirements that (1) the newborn child of a mother who is a Medicaid recipient must continuously reside with the mother for one year after birth; and (2) that the mother remain eligible for Medicaid (or would remain eligible if still pregnant) in order for the child to receive Medicaid benefits for one year after birth. This change enables the state to comply with the amendment to section 1902(e)(4) of the Social Security Act due to CHIPRA of 2009.

The purpose of this amendment is to clarify reasonable limits on amounts for necessary medical or remedial care not covered under Medicaid.

This SPA incorporates the MAGI-based eligibility process requirements, including the single streamlined application, into Hawaii's approved Medicaid State Plan in accordance with the Affordable Care Act.

This amendment modifies the State's reimbursement methodology for setting payment rates for nursing facility services.

This amendment allows pharmacists employed by pharmacies participating in the Kentucky Medicaid program, to be reimbursed a vaccine administration fee at the same rate established to reimburse physicians.

This amendment proposes to extend the date for the triennial assurance of the pharmacy program adherence for "other drugs".

This SPA increases the cost-effectiveness threshold for pursuing recovery from claims related to a trauma code diagnosis.

This amendment proproses to add compounded prescriptions, Mozobil, Ranexa, Rilutek, Soliris, and Xenazine to the list of drugs that require prior authorization.