This state plan amendment aligns payment for certain prescription drugs with Medicare Part B.

This SPA describes the methodology used by the state for determining the appropriate FMAP rates, including the increased FMAP rates, available under the provisions of the Affordable Care Act applicable for the medical assistance expenditures under the Medicaid program associated with enrollees in the new adult group adopted by the state and described in 42 CFR 435.119.

Added coverage for the eligibility group serving individuals under age 65 with incomes at or below 133% of the FPL under Section 1902(a)(10)(A)(viii) of the Social Security Act.

The proposed amendment updates the rate methodology and payment rates for Primary Home Care (PHC) and Community Attendant Services (CAS) to support base wage increases for certain personal attendants. The proposed amendment also revises the initial cost report database to calculate the direct care cost component to be the most recent PHC Medicaid cost report database.

This SPA updated rates and billing codes in alignment with the coding and coverage changes from the Centers for Medicare and Medicaid Services (CMS), the state, and other sources.

This SPA, removes the Medication Therapy Management (MTM) specific section to avoid duplicated language within this section.

Amends the State Plan to update the supplement payment for Critical Access Hospitals.

This amendment proposes to include coverage for blood pressure monitors with an effective date of July 1, 2023.