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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 5561 - 5570 of 15756

Utah
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover testing in non-office locations; provide lab coverage for self-testing; and increase bed hold/therapeutic absence days for nursing facilities and intermediate care facilities for individuals with intellectual disabilities to 60 days per calendar quarter.
Approval Date: June 5, 2020
Effective Date: March 1, 2020
Topics: Benefits Cost Sharing Disaster Relief Long-Term Services & Support

Michigan
This time limited state plan amendment responds COVID-19 emergency. The purpose of this amendment requests changes to cost sharing requirements for testing, quantity limits for DME and medical supplies, transportation requirements and covered laboratory services for beneficiaries covered under traditional Medicaid and the Alternative Benefit Plans. This also amends Telehealth policy and modification of face-to-face requirements, Pharmacy adjustments to quantity limits and prior authorization requirements for automatic renewal. Provider payment rates are increased under this amendment and modifies to person-centered planning requirements, Long-term care facility cost reporting and practitioner licensing requirements.
Approval Date: June 5, 2020
Effective Date: March 1, 2020
Topics: Benefits Cost Sharing Disaster Relief Financing & Reimbursement

District of Columbia
This time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to expand Telehealth, adjustments to 1915(i) adult day health services, adjust day supply limits to allow and reimburse for dispensing of a 90-day supply of maintenance medications, waive physician authorization for LTCSS assessment and request for re-assessment, modify certain payment rates, and to modify the My Health GPS health home program to eliminate acuity tiers, face-to-face requirements, and update care team staffing requirements as well as modify reimbursement methodology.
Approval Date: June 5, 2020
Effective Date: March 11, 2020
Topics: Benefits Disaster Relief Financing & Reimbursement Long-Term Services & Support

Maryland
Makes a technical change previously announced in SPA ID MD-18-0005 to reflect integration into the streamlined application and update the reviewable units for Family Planning to apply the MAGI household rules and income rules to Family Planning Applicants
Approval Date: June 5, 2020
Effective Date: February 1, 2020

Oklahoma
This SPA proposes to establish the reimbursement methodology for high-investment drugs
Approval Date: June 5, 2020
Effective Date: April 1, 2020
Topics: Financing & Reimbursement

New York
Proposes to include a 2% salary increase for certain staff of private psychiatric hospitals. 
Approval Date: June 4, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement Program Administration

Kentucky
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to not applying rate sanctions for the rate quarters of July and October 2020 to the nursing facility per diem rates.
Approval Date: June 4, 2020
Effective Date: July 1, 2020
Topics: Disaster Relief Financing & Reimbursement

Kansas
Replaces manual pricing rules with a fee schedule of reimbursement codes for Total Parental Nutrition (TPN)
Approval Date: June 4, 2020
Effective Date: May 1, 2020
Topics: Financing & Reimbursement

Washington
Adopts the eligibility group described in section 1902(a)(10)(A)(ii)(XIII) of the Social Security Act (the “Work Incentives” eligibility group).
Approval Date: June 3, 2020
Effective Date: January 1, 2020

Alaska
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow licensed practitioners within their scope of practice to order & receive reimbursement for laboratory, radiology and home health services, allow laboratory services to be delivered outside an office, or similar facility other than a hospital outpatient department or clinic, when meeting the state’s provider qualifications.
Approval Date: June 3, 2020
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief