This State Plan Amendment was submitted to amend the provisions governing third party liability in order to clarify language around preventive pediatric services, child support enforcement, and prenatal services, as well as to update policies and procedures.

updates the methodology for Disproportionate Share Hospitals (DSH).

continues to authorize supplemental payments to qualifying nursing facilities located in a county of the first class.

the amendment will continue to authorize Medical Assistance Day One Incentive (MDOI) payments to qualifying nonpublic nursing facilities.

authorizes supplemental payments to qualifying acute care general hospitals located in a county with an estimated general population count of less than one million that serve a high percentage of Medical Assistance patients.

increased the hourly rate for Applied Behavioral Analysis (ABA) to $55.

This amendment provides for Proportionate Share Incentive (ProShare) Adjustment I and II eligible county changes.

provides for reallocation of the Arizona disproportionate share hospital (DSH) pool 4 funds
to pool 5, for the DSH state plan rate year ending 2020.

Tennessee is submitting this SPA to add language regarding Clinical Trial Coverage as directed by the Consolidated Appropriations Act, 2021.

To add coverage for Virginia’s Alternative Benefit Plan Medicaid Works, Routine Patient Cost in Qualifying Clinical Trials.