Proposed to use 51 percent of the Federal Poverty Level (FPL) for the Modified Adjusted Gross Income (MAGI) standard for individuals eligible through the reasonable classification groups under 42 CFR 435.222 rather than the fixed dollar standards previously used. This is the same percentage used by the federally facilitated marketplace when assessing Medicaid eligibility for this group. Use of the FPL percentage income test will provide a more seamless coordination with the health care marketplace and reduce the administrative complexity of making eligibility determinations.

This SPA is to limit allowable pre-eligibility medical expenses applied to reduce recurring income for long term care services to expenses incurred in the three months prior to the month of the Medicaid application.

This SPA proposes to implement presumptive eligibility conducted by hospitals in the Medicaid state plan in accordance with the Affordable Care Act.

This SPA proposes to amend New Jersey's Alternative Benefit Plan to include Managed Long Term Services and Supports and to increase mental health and substance use disorder rates in order to more closely align with existing state rates currently paid by the Division of Mental Health & Addiction Services.

This amendment revises reimbursement for inpatient hospital services. It specifies an All Patient Refined-Diagnosis Related Group (ARPDRG) Version 31 reimbursement system that the state has been paying under the 1115 waiver since July 1, 2010.

This amendment revises the annual disproportionate share hospital (DSH) payments. Specifically, it updates the base year for determining uncompensated care cost from 2012 to 2014. It also revises the limits for certain DSH pools.

Certain equipment, supplies, and transportation services: Payment for services provided to beneficiaries in a nursing facility (NF).

The state proposes to change the dispensing fee for compounded prescriptions to a tiered rate based on the pharmacist's reported level of effort.

This SPA assures that Tennessee is in compliance with 42 CFR §455.434 as it relates to providers criminal background checks and fingerprinting requirements.

This SPA revises the State's reimbursement methodology for setting payment rates for Psychiatric Residential Treatment Facilities (PRTFs).