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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 731 - 740 of 15689

Idaho

This amendment revises Idaho’s Basic Alternative Benefit Plan to add the following services: Assertive Community Treatment, Parenting With Love and Limits, and Inpatient Psychiatric Services for Individuals Under Age 21 in Psychiatric Facilities or Programs.

Approval Date: August 29, 2024
Effective Date: July 1, 2024
Topics: Alternative Benefit Plan

Idaho

This amendment revises Idaho's Enhanced Alternative Benefit Plan to add the following services: Assertive Community Treatment, Parenting With Love and Limits, and Inpatient Psychiatric Services for Individuals Under Age 21 in Psychiatric Facilities or Programs.

Approval Date: August 29, 2024
Effective Date: July 1, 2024
Topics: Alternative Benefit Plan

Kentucky

This amendment is an extension of the state’s approved exception to establishing a recovery audit contractor.

Approval Date: August 29, 2024
Effective Date: July 1, 2024
Topics: Program Administration

North Carolina

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.

Approval Date: August 29, 2024
Effective Date: April 1, 2024
Topics: Coverage Prescribed Drugs Prescription Drugs

Texas

This SPA proposes to amend the State Plan to create a new, temporary non-preferred status, and establish criteria for new-to-market drugs that have not yet been reviewed by the Drug Utilization Review Board.

Approval Date: August 29, 2024
Effective Date: September 1, 2025
Topics: Coverage Drug Utilization Review (DUR)

Massachusetts

This SPA proposes to amend the State Plan to cover prescribed drugs when medically necessary during drug shortages identified by the United States Food and Drug Administration (FDA).

Approval Date: August 29, 2024
Effective Date: June 26, 2024
Topics: Coverage Drug Shortages Prescription Drugs

Minnesota

This SPA amends effective date for Community First Services and Supports (CFSS) from June 1, 2024, to October 1, 2024.

Approval Date: August 29, 2024
Effective Date: October 1, 2024
Topics: Coverage and Reimbursement Home and community based services

Minnesota

This SPA amends effective date for Community First Services and Supports (CFSS) from June 1, 2024, to October 1, 2024.

Approval Date: August 29, 2024
Effective Date: October 1, 2024
Topics: Coverage and Reimbursement Home and community based services

Wisconsin

This plan amendment updates the methods of implementation for NHs to eliminate the supplemental payment award to county homes and convert it into a prospective per-diem add-on for those facilities.

Approval Date: August 29, 2024
Effective Date: April 1, 2024

New Hampshire

This amendment indicates that New Hampshire complies with the Consolidated Appropriations Act Chapter 146, Laws of 2024 (SB312) regarding third-party liability.

Approval Date: August 27, 2024
Effective Date: July 1, 2024
Topics: Preventive Services Reimbursement Third Party Liability