This state plan amendment will allow Medicaid to move the authority for the per member per month enhanced management fees for primary care providers participating in the Carolina Access program from the Primary Care Case Management section of the state plan to the physician reimbursement section of the Medicaid State Plan.

This amendment adds day habilitation, a clubhouse, and two specialized add-on services.

This plan updates rates for exams performed by the Disability Determination Unit (DDU).

This SPA is adding mandatory benefits regarding coverage of COVID-19 vaccines, testing, and treatments to the Medicaid State Plan. The state submitted the completed ARP preprints for COVID Vaccines, Testing, and Treatment.

Effective October 1, 2022, this amendment proposes rate year ((RY) 2023 updates to reimbursement methods and standards for privately owned psychiatric hospitals and substance abuse treatment hospitals.

Effective October 1, 2022, this amendment makes comprehensive updates for rate year (RY) 2023 reimbursement methods and standards for nursing facilities.

This SPA updates the effective date for the addition of a new CCBHO provider.

This amendment updates methods and standards for establishing Medicaid Disproportionate Share Hospital (DSH)
payments to qualifying DSH hospitals using the FY ending 2021 base year cost reporting period to calculate interim DSH payments; updates the inflation rate used to trend the DSH base year cost to the end of the 2021 calendar year; updates swing bed and administrative day rates based upon the October 1, 2022, redetermination of nursing facility payment rates; and updates the statewide outpatient hospital fee schedule relating to Vagus Nerve Stimulation codes.

The purpose of this SPA is to amend the provisions governing inpatient hospital services in order to expand the qualifications for classification as a teaching hospital to include facilities that have documented affiliation agreements with Louisiana medical schools accredited by the Commission of Osteopathic College Accreditation (COCA).