Continuing supplemental payments to private nursing facilities that meet certain criteria and operate in a county of the eighth class.

Continuing disproportionate share hospital payments to acute care facilities to enhance Medicaid access in less urbanized areas of Pennsylvania.

This SPA increases the standards for the optional State supplementary payment program.

This SPA increases the amount of allowable home equity interest for individuals seeking Medicaid eligibility for nursing facility services or other long-term care services.

This state plan amendment allows for the utilization of non-emergency medical transportation (NEMT) broker for the fee-for-service population effective January 1, 2018. The NEMT broker will receive a capitated monthly all-inclusive rate to service all fee for service members. The amendment also allows for the reimbursement of meals and lodging.

This SPA extends the elimination of inflation rate increases for multiple services into a third state fiscal year (2018), and implements targeted rate cuts for selected services.

Changes to the reimbursement methodology for covered outpatient drugs from an estimated acquisition cost (EAC) basis to an actual acquisition cost basis (AAC).

This amendment updates the tobacco cessation services sections of the state plan to provide for coverage of Food and Drug Administration (FDA) approved tobacco cessation medications and tobacco cessation services recommended by the U.S. Preventive Services Task Force.

This SPA was originally submitted as part of SPA No. 09-010, which was subsequently split into three parts. SPA 09-010(C) revises your approved Title XIX State plan to update the reimbursement methodologies for multiple services.

UPDATED 11/17/2020 - The approved page inadvertently contained a typographical error in describing Private Duty Nursing Level IV reimbursement at $11,570 per month—the correct reimbursement amount of $1,570 per month is included in the attached pages. The official approval date remains May 24, 2018.