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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 2011 - 2020 of 15755

Colorado

3% rate increase per state budget bill.

Approval Date: August 24, 2023
Effective Date: July 1, 2023

New York

To allow pharmacists and pharmacy interns to provide Medicaid covered services to the limits of their scope of practice.

Approval Date: August 24, 2023
Effective Date: April 1, 2023
Topics: Other Licensed Practitioners

New Hampshire

Disproportionate Share Hospital (DSH) Payment Adjustments

Approval Date: August 23, 2023
Effective Date: May 24, 2023

California

Medi-Cal reimbursement methodology for State Fiscal Year 2023-24 Diagnosis Related Group? Payments.

Approval Date: August 23, 2023
Effective Date: July 1, 2023

New York

This SPA proposes to modify language on the excluded drug coverage pages to reflect coverage of selective medications by referencing the state’s webpage resources instead of listing specific covered medications.

Approval Date: August 22, 2023
Effective Date: April 1, 2023
Topics: Coverage Prescribed Drugs

Louisiana

The purpose of this SPA is to amend the provisions governing rural health clinics (RHCs) in order to remove the cutoff date to allow existing RHCs licensed as small rural hospital outpatient departments after July 1, 2007 and new RHCs to be reimbursed at 110 percent of cost.

Approval Date: August 22, 2023
Effective Date: July 1, 2023

New Mexico

This SPA proposes Family Infant Toddler (FIT) Rate Increases.

Approval Date: August 22, 2023
Effective Date: July 1, 2023

Illinois

This SPA proposes to update the language on the state’s excluded drug list, including provisions for coverage of select over-the-counter (OTC) drugs.

Approval Date: August 21, 2023
Effective Date: April 1, 2023
Topics: Coverage Prescribed Drugs

New York

This amendment proposes to establish a new methodology for the Minimum Data Set (MDS) data in the calculation of the case mix index.

Approval Date: August 21, 2023
Effective Date: July 1, 2021

Montana

This State Plan Amendment updates the bundled composite rate for services provided in outpatient maintenance dialysis clinics.

Approval Date: August 21, 2023
Effective Date: July 1, 2023