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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 671 - 680 of 15693

New Mexico

This amendment adds chiropractic services and establishes a Medicaid reimbursement methodology.

Approval Date: September 16, 2024
Effective Date: October 1, 2024
Topics: Coverage and Reimbursement

Kentucky

Creates a new specialty Rural Emergency Hospital under clinic services.

Approval Date: September 16, 2024
Effective Date: April 1, 2024

Michigan

Recognizes the shift to require managed care plans to cover transportation to all Medicaid-covered services, clarifies coverage
language, and reflects other technical adjustments.

Approval Date: September 16, 2024
Effective Date: October 1, 2024

Pennsylvania

This plan continues a temporary extension of an Alternative Payment Methodology (APM) for Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC). This APM will continue to provide coverage without copay or cost-sharing, for the administration of COVID-19 vaccines by staff who have the authority under state law to administer the vaccine, in the FQHC and RHC settings during a COVID-19 vaccine-only visit through September 30, 2024.

Approval Date: September 16, 2024
Effective Date: May 12, 2024

Illinois

This plan amendment updates rates for dental anesthesia and Substance Use Disorder (SUD) services.

Approval Date: September 13, 2024
Effective Date: July 1, 2024

Louisiana

The purpose of this SPA is to adopt provisions governing qualifying criteria and reimbursement methodology for high Medicaid utilization academic hospitals in order to increase payments for
outpatient hospital services.

Approval Date: September 13, 2024
Effective Date: July 1, 2024

Kentucky

Updates the personal needs allowance from $40 to $60.

Approval Date: September 13, 2024
Effective Date: July 1, 2024

Virginia

Disregards portions of Social Security Disability Insurance (SSDI) income when calculating financial eligibility for certain sections 1915(c) waivers.

Approval Date: September 13, 2024
Effective Date: July 1, 2024

Puerto Rico

Extension of eligibility to certain individuals who are deemed to be receiving AFDC.

Approval Date: September 13, 2024
Effective Date: May 29, 2024

New Hampshire

This amendment adds enhanced mobile crisis services to the Medicaid state plan.

Approval Date: September 12, 2024
Effective Date: April 1, 2024
Topics: Coverage and Reimbursement