This state plan amendment proposes to amend the provisions governing reimbursement for professional services in the Medical Assistance program to establish provisions governing a one percent Federal Medical Assistance Percentage (FMAP) point increase for the coverage of specific adult vaccines and clinical preventative services provided on a fee for service or managed care basis.

This state plan amendment proposes to reinstate the Louisiana Health Insurance Premium Payment (LAHIPP) program in order to reduce Medicaid costs by establishing or maintaining a third party resource as the primary payer of the Medicaid recipient's medical expenses.

This state plan amendment proposes to exclude the Louisiana Health Insurance Premium Payment (LAHIPP) enrollees from participation in managed care for physical and behavioral health.

To include the terms upon which the state will collect supplemental rebates from drug manufacturers on those drugs dispensed to Medicaid Managed Care Organizations (MCO) enrollees.

Coverage and Limitations, and Payment for Services and Ambulatory Health Care Clinic Services.

The companion letter requested the state to clearly define and describe rehabilitation services and to identify the requirements for practitioner providers.

This SPA removes the exclusion that currently exists for hippo-therapy.

Health Homes Face-to-Face Requirements.

This SPA proposes to bring New Jersey into compliance with the reimbursement requirements in the Covered Outpatient Drug final rule with comment period (CMS-2345-FC).

The SPA proposes to carve out the administration of the Long-Acting Reversible Contraceptive (LARC) from the APG reimbursement methodology when it is provided on the same Date of Service (DOS) as an abortion.