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Medicaid State Plan Amendments

A Medicaid and CHIP state plan is an agreement between a state and the Federal government describing how that state administers its Medicaid and CHIP programs. It gives an assurance that a state will abide by Federal rules and may claim Federal matching funds for its program activities. The state plan sets out groups of individuals to be covered, services to be provided, methodologies for providers to be reimbursed and the administrative activities that are underway in the state.

When a state is planning to make a change to its program policies or operational approach, states send state plan amendments (SPAs) to the Centers for Medicare & Medicaid Services (CMS) for review and approval. States also submit SPAs to request permissible program changes, make corrections, or update their Medicaid or CHIP state plan with new information.

Persons with disabilities having problems accessing the SPA PDF files may call 410-786-0429 for assistance.

Results

Displaying 3491 - 3500 of 15693

Idaho
This SPA expand passive enrollment of the Medicare-Medicaid Coordinated Alternative Benefit Plan to three additional counties where there is only one participating health plan.
Approval Date: June 13, 2022
Effective Date: April 1, 2022
Topics: Average Sales Price (ASP)

Colorado
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to  allow the state Medicaid agency to reimburse FQHCs at the fee schedule amount for administration of Covid-19 vaccines.
Approval Date: June 10, 2022
Effective Date: January 1, 2021
Topics: Disaster Relief Reimbursement

Colorado
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to add a Nursing Facility payment 4/1/22-6/30/22 and correct ASC procedure code 36561 payment amount from $1,813.06 to $1,831.06, effective 8/26/2021.
Approval Date: June 10, 2022
Effective Date: August 26, 2021
Topics: Disaster Relief Reimbursement

Guam
This SPA will update Third Party Liability (TPL) requirements as authorized under the Bipartisan Budget Act (BBA) of 2018 and the Medicaid Services Investment and Accountability Act (MSIAA) of 2019.
Approval Date: June 10, 2022
Effective Date: April 1, 2022

Indiana
This amendment modifies coverage requirements for routine patient costs associated with participation in clinical trials.
Approval Date: June 9, 2022
Effective Date: June 1, 2022

Louisiana
This amendment proposes to implement coverage of routine patient costs associated with participation in qualifying clinical trials.
Approval Date: June 9, 2022
Effective Date: January 1, 2022
Topics: Coverage and Reimbursement

Louisiana
This SPA is to amend the pharmacy pages provisions to cover select over the counter (OTC) medications.
Approval Date: June 8, 2022
Effective Date: February 9, 2022

Oklahoma
This amendment establishes Partial Hospitalization Program (PHP) services for individuals ages 21 through 64 with substance use disorder, mental health diagnoses, and/or co-occurring disorders
within the Medicaid state plan.
Approval Date: June 8, 2022
Effective Date: September 1, 2022
Topics: Coverage and Reimbursement

Oklahoma
This amendment revises the state’s Alternative Benefit Plan (ABP).
Approval Date: June 8, 2022
Effective Date: January 1, 2022

Michigan
authority for consolidating the Disproportionate Share Hospital (DSH) process into two steps.
Approval Date: June 7, 2022
Effective Date: January 1, 2022
Topics: Program Administration