CMS is issuing a technical correction to the approval package for TX-22-0028. TX-22-0028 introduced Page 1 of Supplement 5 to attachment 4.19-B as a NEW page, however a previously approved SPA already added Page 1 of Supplement 5 to attachment 4.19-B. This technical correction will make the page added by TN 22-0028 Page 1-a.

This SPA terminates the Hemophilia program arrangement with the South Carolina Department of Health and Environment Control Agency, at their request.

This amendment provides for a rate adjustments for Outpatient Hospitals.

Describes the State’s Drug Utilization Review (DUR) program.

This SPA has been submitted as related to the Inflation Reduction Act of 2022 temporary, 5-year increase for physician administered biosimilar drugs that will be paid Medicare's Average Sales Price (ASP) plus 8% (rather than plus 6%).

This plan amendment updates the physician services alternative payment model (APM) by changing the time-frame for eligible payments that qualify primary care medical providers (PCMP) for the APM, thereby, making the APM code set
timeline prospective and ongoing rather than tied to specific past dates, and pushing the 2021 APM rate adjustments
back from July 1, 2021 to October 1, 2021.

This SPA proposes to allow the state to enter into Value Based Agreements, as well as updating the state's Pharmacy coverage pages.

This State Plan Amendment (SPA) revises the reimbursement for FQHC and RHC providers to pay for long acting
reversible contraception devices separately from the prospective payment system.

This SPA updates the reimbursement methodology for limited orthodontic treatment.

This plan amendment updates hearing aid dispensing rates and clarifies existing hearing aid payment language.