This SPA was submitted to annotate that the state requires providers to bill liable third parties when services covered under the Plan are furnished to a member on whose behalf child support enforcement is being carried out

Requests an exception of the State’s requirement to contract with a Medicaid Recovery Audit Contractor

This amendment proposes to add medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan

Effective April 1, 2021, this amends the state's coverage pages to include updates to covered over-the-counter items. 

Effective July 1, 2021, this amendment implements an increase to the professional fee schedule for vaccine administration under the Pediatric Immunization program. 

Effective April 1, 2021, this amendment updates the physician office and outpatient fee schedule to incorporate various Healthcare Common Procedure Coding System (HCPCS) updates (additions, deletions and description changes) from the most recent HCPCS quarterly update issued by CMS. Codes that are being added are being priced using a comparable methodology to other codes in the same or similar category. 

Effective April 1, 2021, this amendment updates the DME fee schedule to incorporate the April 2021 Healthcare Common Procedure Coding System (HCPCS) changes to remain compliant with the Health Insurance Portability and Accountability Act (HIPPA). Newly added codes are priced using a comparable methodology to other codes in the same or similar category.

Increases the rates for Behavioral Health, Health Home Program by 3.5% beginning January 1, 2021

Effective July 20, 2021, this amendment revises the reimbursement methodology for outpatient services.