This plan amendment extends the current hospital provider payment program through June 30, 2030, per the provisions of O.C.G.A. §31-8-179.6. This applies to inpatient and outpatient hospital services.

This plan amendment updates All Patient Refined Diagnosis Related Group (APR-DRG) reimbursement rates for inpatient hospital services effective October 1, 2024.

This plan amendment updates the fee schedule for long term acute care and rehabilitation hospital inpatient rates effective October 1, 2024.

This plan amendment will be discontinue the Rate Relief Program to simplify the Michigan Medicaid Long Term Care Reimbursement Methodology and make changes to make it less complicated, less labor intensive and more efficient.

This amendment proposes to align the Alternative Benefit Plan with the Medicaid state plan by adding asthma prevention services, community health worker services, and coverage of routine patient costs in clinical trials.

This amendment is to align the Alternative Benefit Plan with the Medicaid state plan by adding doula services and updates the Federally Qualified Health Centers (FQHC) and Rural Health Clinic (RHC) services category to include associate marriage and family therapist (AMFT) services and associate clinical social worker (ACSW) services.

This amendment is to align the Alternative Benefit Plan with the Medicaid state plan by allowing FQHCs and RHCs to bill for encounters by licensed professional clinical counselors and associate professional clinical counselors.

This amendment is to align the Alternative Benefit Plan with the Medicaid state plan by adding pharmacies as supervisors for Community Health Workers. This SPA also updates the ABP to add peer support services, Drug Medi-Cal Organized Delivery Systems SUD treatment, and mobile crisis teams.

This plan amendment updates the Medically Monitored Inpatient Withdrawal Services reimbursement rate.

This plan amendment updates the inpatient hospital Differential Adjusted Payment (DAP) program for contract year ending 2025.