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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 3321 - 3330 of 15777

West Virginia
To establish a targeted case management benefit for Medicaid eligible pregnant and post-partum individuals who are in the Drug Free Moms and Babies (DFMB) program.
Approval Date: September 6, 2022
Effective Date: June 9, 2022

Montana
The purpose of this amendment is to temporarily increase payment rates for fee for service state plan home and community based services through quarterly supplemental payments based upon a percentage of Medicaid allowable paid claims in order to maintain a stable workforce and preserve services during the declared public health emergency.
Approval Date: September 2, 2022
Effective Date: April 1, 2022
Topics: Disaster Relief Home and community based services Reimbursement

Missouri
This State Plan Amendment ensures that the Health Insurance Premium Payment (HIPP) Program in Missouri operates in the most efficient and cost-effective manner possible by eliminating areas where Medicaid may be paying for multiple premiums on behalf of the same participant.
Approval Date: September 1, 2022
Effective Date: January 1, 2023

Ohio
To update state plan language related to the coordination of benefits for hospital services and remove obsolete rules-based language that is no longer pertinent.
Approval Date: September 1, 2022
Effective Date: June 2, 2022

Washington
Implement changes to payments to hospitals meeting certain criteria for Sole Community Hospitals (SCH). ESSB 5693 separated the
rates into two categories - one for Sole Community Hospitals (SCH), and one for SCHs taking single bed certifications (SBCs).
Approval Date: September 1, 2022
Effective Date: July 1, 2022
Topics: Financing & Reimbursement

Kansas

Approves the reimbursement methodology for Dispensed As Written (DAW1) drugs.

Approval Date: September 1, 2022
Effective Date: June 1, 2022
Topics: National Average Drug Acquisition Cost (NADAC) Prescribed Drugs

Ohio
Updates pages for payment of Eyeglasses.
Approval Date: August 31, 2022
Effective Date: July 1, 2022
Topics: Financing & Reimbursement

Rhode Island
This amendment proposes to provide First Connections program services to pregnant women.
Approval Date: August 31, 2022
Effective Date: April 26, 2022
Topics: Coverage and Reimbursement

California
Updates California's All Patient Refined Diagnosis Related Group (APR-DRG) payment parameters for state fiscal year 2022-2023.
Approval Date: August 30, 2022
Effective Date: July 1, 2022
Topics: Financing & Reimbursement

Kansas
Increases reimbursement rates for ambulance services.
Approval Date: August 30, 2022
Effective Date: July 1, 2022
Topics: Financing & Reimbursement