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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 51 - 60 of 15689

North Dakota

This plan amendment updates the inflation factor for Psychiatric Residential Treatment Facilities (PRTF) daily rates.

Approval Date: April 9, 2025
Effective Date: January 1, 2025

Idaho

This plan amendment updates fee schedules language for service rehabilitation benefits section to comply with federal requirements and updates outdated language.

Approval Date: April 8, 2025
Effective Date: July 1, 2024

Minnesota

This amendment updates rates for mental health services according to the resource-based relative value scale (RBRVS).

Approval Date: April 8, 2025
Effective Date: January 1, 2025

Michigan

This plan amendment increases the amount of its GME Innovations agreement with Pine Rest Christian Mental Health Services.

Approval Date: April 8, 2025
Effective Date: January 1, 2025

Kansas

This plan amendment updates the Critical Access Hospital (CAH) cost report settlements. These funds will be split between inpatient CAH Adjustment Factor (CAF) settlements and outpatient CAF settlements using the same percentage split as the inpatient and outpatient CAF settlements in 2013.

Approval Date: April 8, 2025
Effective Date: January 1, 2025

Michigan

This SPA allows coverage of medically necessary prescribed drugs that are not covered outpatient drugs, including drugs authorized for import by the U.S. Food and Drug Administration (FDA), during drug shortages. In addition, this SPA proposes to reimburse prescribed drugs that are not considered covered outpatient drugs utilizing the same methodologies as covered outpatient drugs.

Approval Date: April 8, 2025
Effective Date: January 1, 2025
Topics: Coverage Prescribed Drugs Reimbursement

Connecticut

This amendment extends coverage to members residing in a broader geographic area that qualify for Target Case Management (TCM) benefits for Integrated Care for Kids (InCK) in New Haven, Connecticut.

Approval Date: April 8, 2025
Effective Date: January 1, 2025
Topics: Targeted Case Management

Alaska

This Alternative Benefit Plan amendment aligns with Medicaid State Plan to exempt general acute hospitals, reimbursed under the diagnosed related group (DRG) payment methodology, from continued stay service authorizations.

Approval Date: April 8, 2025
Effective Date: February 1, 2025
Topics: Alternative Benefit Plan

Puerto Rico

To enable Puerto Rico to enter into direct arrangements with pharmaceutical manufacturers for supplemental rebates and value-based or outcomes-based agreements.

Approval Date: April 7, 2025
Effective Date: January 1, 2025

Alaska

This amendment exempts general acute care, reimbursed under the diagnosed related group (DRG) payment methodology, from continued stay service authorizations.

Approval Date: April 4, 2025
Effective Date: February 1, 2025
Topics: Coverage Other Licensed Practitioners Prior Authorization Reimbursement