PUBLIC NOTICE
WEST VIRGINIA MEDICAID
PROGRAM STATE PLAN
AMENDMENT 18-004
REGARDING
ALTERNATIVE BENEFIT PLAN
PURSUANT TO THE PATIENT
PROTECTION AND
AFFORDABLE CARE ACT
ALTERNATIVE TREATMENTS
FOR CHRONIC PAIN
MANAGEMENT
In accordance with 42 CFR 440.386 The Department of Health and Human Resources, Bureau for Medical Services (“Bureau”) provides notice of its intent to file a state plan amendment (SPA), identified as SPA 18-004, with the Centers for Medicare and Medicaid Services (CMS) to modify the delivery system for Medicaid members receiving the Alternative Benefit Plan (ABP) in accordance with Patient Protection and Affordable Care Act (ACA). West Virginia expanded Medicaid on January 1, 2014 to individuals aged 19 – 64 with income up to 133{4ceb532c6f579389df471c6c1e832caf2346b74dc60fcbf6aabd4d29df3baf9c} of the federal poverty level.
The SPA provides for, under the alternative benefit plan, 20 combined visits of physical therapy, occupational therapy, osteopathic manipulation, chiropractic services, or other non-surgical, non-prescription drug treatments related to a chronic pain management program, without need for a referral. This SPA is prompted by Senate Bill 273, enacted by the Legislature and signed by the Governor in during the West Virginia 2018 Regular Legislative session. Specifically, see new code provision West Virginia Code 16-54-8.
Consistent with 42 CFR 440.345, the Bureau assures that there will be full access to EPSDT services for people under 21 years of age. The expected fiscal impact for fiscal years 2019 and 2020 cannot be determined at this time.
This Notice is intended to satisfy 42 CFR 440.386 and all other Federal and State notice requirements.
Documents detailing these proposed actions will be available for public inspection in each county office of the Department of Health and Human Resources during normal business hours, 8:30 a.m. to 4:30 p.m., beginning Friday, August 24, 2018, until Monday, September 24, 2018, and on the web at: www.dhhr.wv.gov/bms under “Public Notices”. Written comments may be sent to the West Virginia Department of Health and Human Resources, Bureau for Medical Services, 350 Capitol Street, Suite 251, Charleston, WV 25301-3706, or by email at [email protected].
8-23-THU-1-RH; LG 134652
ID: 134652