CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to implement coverage of COVID-19 vaccine administration and COVID-19 Test administration when provided by pharmacists, pharmacy interns and pharmacy technicians, to the extent authorized by the PREP Act; and 2) Effective December 11, 2020, establish reimbursement rates for the COVID-19 vaccine administration at 100% of the Medicare rate.

Allows Dual Special Needs Plans to contract to furnish previously approved ADHP services under the provisions of §1915(a)(l ), which serves all geographic areas in the District, through capitated monthly payments made to the health plan.

Adds a new licensed provider type (dental therapists) to the Oregon State Plan.

Brings the State Plan into compliance with the TPL requirements under the BBA of 2018 and the MSIAA of2019.

Updates to Third Party Liability activities to comply with
federal regulations.

Requests a waiver extension to the Federal requirements for implementing a Recovery Audit Contractor (RAC) program.

This amendment ensures compliance with Section 209 of the Consolidated Appropriations Act of 2021. CMS supports this change because it brings the state into compliance.

Revises the language describing the methodology used to calculate the capitation rate payment for PACE organizations. The SPA will remove the Medicare Economic Index ( MEI) adjustment from the rate methodology, as the PACE capitation rate is based on the amount that would otherwise be paid (AWOP) which is reviewed annually and adjusted as needed, without regard to the MEI.

Updates prescribing providers for preventive services from only physicians to license practitioners within the scope of their license which is in line with industry standards and federal language.