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

This amendment is to define the Alternative Benefit Plan (ABP) that will be used to implement certain requirements for the new North Carolina Medicaid Expansion eligibility group as required by SL 2023-7.  The Act allows for the inclusion of Medicaid eligibility to individuals aged 19‐64 with incomes at or below 133 percent of the federal poverty level who are not enrolled in or eligible for Medicare, consistent with the new adult group eligibility criteria as defined by the Affordable Care Act.

To reflect a four percent (4.0%) cost of living adjustment for Care Coordination Organization/Health Homes rates for individuals with intellectual and developmental disabilities.

This SPA provides Missouri with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.