Purpose of SPA is to revise or add various coverage and reimbursement state plan pages to sustain certified community behavioral health services beyond Demonstration period

This is MACPro companion SPA ID-19-0001, cost of living Adjustments adds to the MACPro system Idaho's non MAGI methodologies.

Purpose of this SPA is to request an extension of the exemption from participation in the Recovery Audit Contractor (RAC) program.

Proposes to update the state's, The Optimal PDL $olution (TOP$) supplemental rebate agreement to include MCO utilization.

Clarifies clinic reimbursement is based on a published fee schedule and includes a 3. 8% rate reduction that was necessary to meet UPL requirements.

Update the substance use disorder services language.

Revises payment rates to support changes in the allowable units of certain service codes. Also deletes language describing certain payment adjustments.

Amends the State Plan to update the designee for State Plan submissions.

Amend provisions governing reimbursementin the Pharmacy Benefits Management Program in order to increase professional dispense fee.

Proposes to amend the number of days of medication that can be dispensed for Medicaid recipients for certain prescription drugs.