Unnecessary Use of Care and Services Medicaid State Plan Amendment 23-0020 Public Notice

Notice: Unnecessary Use of Care and Services Medicaid State Plan Amendment 23-0020 Public Notice is now available online.

Description: HCA intends to submit SPA 23-0020 to address information that was identified by state auditors during the agency’s State Fiscal Year 21 (SFY21) Single Audit as missing from the Medicaid State Plan regarding methods and procedures to safeguard against unnecessary utilization of care and services. SPA 23-0020 will indicate that the state directly oversees a surveillance and utilization control program and that an entity that meets the requirements of the Social Security Act performs annual quality assurance reviews of managed care organizations.