This amendment proposes to provide a lump sum payment for eligible nursing facilities that are facing financial challenges and are participating in the health, retirement, and training benefit fund.

This amendment allows MO HealthNet to consider participants eligible for, but not enrolled in, a managed care plan for
the Health Insurance Premium Payment (HIPP) program, and determine whether enrolling such participants in HIPP would be cost effective.

This plan amendment updates the payment methodology for clinical laboratory services.

This SPA amends the reimbursement methodology for bio-engineered substitutes (skin graft) to the lower of the amount billed, the charge to the general public, or 100 percent of corresponding Medicare Average Sales Price (ASP) rate.

Effective October 1, 2022, this amendment updates rate year 2023 reimbursement methods and standards for acute and critical access inpatient hospital services.

This amendment modifies the eligibility criteria for Ohio’s Comprehensive Primary Care (CPC) program to prevent duplication of payments for CPC services and the new Comprehensive Maternal Care program services.  This SPA also re-aligns quality metrics to reflect accurate industry terminology.

This amendment seeks to add Behavioral Support Aides as a new service in the State of Georgia. This new service will provide in home behavioral support aides to children in the home and community-based setting.

This amendment requests for an exception from the Medicaid Recovery Audit Contractor (RAC) requirements.