STATE OF HAWAII DEPARTMENT OF HUMAN SERVICES MED-QUEST DIVISION PUBLIC NOTICE Pursuant to 42 C.F.R. §447.205, the Department of Human Services (DHS), Med-QUEST Division (MQD) hereby notifies the public that the MQD intends to submit a State Plan Amendment to the Centers for Medicare and Medicaid Services (CMS). Under provisions of federal law, the state is required to issue public notice of proposed changes in statewide methods and standards for setting Medicaid payment rates. The proposed changes will update Attachment 4.19-B, Non-Institutional Items and Services: to include Dental rates effective 03/01/2020, Early Periodic Screening, Diagnostic and Treatment, Home Pharmacy, Home Health Agency and Medical Supplies rates that were set on or after-effective 06/24/2020. Payment for Laboratory and X-ray services shall be at the current Medicaid Fee Schedule. The state plan amendment is posted at https://medquest.hawaii.gov/en/about/state-plan-1115.html and the amended fee schedules are posted at https://medquest.hawaii.gov/en/plans-providers/fee-for-service/fee-schedules.html SPA 20-0003 is expected to have minimal effect on the annual aggregate expenditure’s reimbursement for dental, EPSDT, home pharmacy services, medical supplies and home health agency services. The proposed change will be submitted for review to the federal government as a Medicaid State Plan Amendment (SPA) to be effective December 1, 2020. Comments should be received within 30 days from the time this notice is posted. Individuals may submit written comments using the following methods: By email: emauricio@dhs.hawaii.gov (Please identify in the subject line: State Plan Amendment 20-0003) By mail: Department of Human Services Med-QUEST Division Attention: Policy and Program Development Office P.O Box 700190 Kapolei, Hawaii 96709 A copy of the proposed changes is available for public viewing from the first working day the public notice appears in the Honolulu Star-Advertiser, Hawaii Tribune Herald, West Hawaii Today, The Maui News, and The Garden Island. A printed copy of the proposed changes and special accommodations (i.e., interpreter, large print or taped materials) can be arranged if requested by contacting the Policy and Program Development Office at (808) 692-8058 no later than seven (7) working days before the comment period ends. DEPARTMENT OF HUMAN SERVICES, MED-QUEST DIVISION JUDY MOHR PETERSON, PhD MED-QUEST DIVISION ADMINISTRATOR (HTH1304690 11/30/20)