This plan amendment proposes to increase the CFTSS Children’s Medicaid rates by 2.84% for the Cost of Living Adjustment (COLA).

This plan amendment proposes to provide a 2.84% COLA for OASAS freestanding outpatient services, Part 820 residential services, freestanding residential medically supervised withdrawal, and freestanding residential rehabilitation.

This amendment updates HCPCS reimbursement to physician office & outpatient/radiology/surgery, independent radiology, MEDS, lab, adult/children dental services, audiology/speech & language, ambulatory surgical centers, rehab/medical and behavioral health clinics. This SPA also updates reimbursement to physician admin drugs; adult complex skilled nursing services; long-acting reversible contraceptives (LARCs) and adds periodontal SRP services. It also extends rate add-ons for pediatric inpatient psych and the states person centered medical homes (PCMH+) program.

This amendment waives the Recovery Audit Contractor (RAC) Program.

This amendment establishes coverage for Biomarker Tests that are medically necessary.

Disregards portions of Social Security Disability Insurance (SSDI) income when calculating financial eligibility for certain sections 1915(c) waivers.

This plan amendment updates the per diem rates for non-publicly owned hospitals will be increased and payment for services provided under the Substance Using Pregnant People program is an exception to the per diem rate determination for specialty services.

This plan amendment provides additional payments to non-state government public residential health care facilities.