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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 4981 - 4990 of 15843

New York
This amendment clarifies the existing methodology for distribution of the rural enhancement for personal care services. 
Approval Date: March 30, 2021
Effective Date: July 1, 2020
Topics: Federal Financial Match Program Administration

New Jersey
This amendment updates 2020 Medicaid Fee Schedules.
Approval Date: March 30, 2021
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

North Carolina
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this COVID - 19 Medicaid Disaster Relief Round 7 State plan amendment is to allow pharmacists to administer vaccines for COVID-19.
Approval Date: March 29, 2021
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief

Massachusetts
This plan amendment updates the methods and standards to set payment rates for acute outpatient hospitals.
Approval Date: March 29, 2021
Effective Date: October 1, 2020
Topics: Financing & Reimbursement

Illinois
Effective October 1, 2019, this amendment allows the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271).
Approval Date: March 26, 2021
Effective Date: October 1, 2019
Topics: Prescription Drugs Program Administration

California
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to increase the reimbursement of oxygen, oxygen equipment and respiratory equipment to 100% of the corresponding Medicare rates and exempt these rates from the 10 percent payment reductions authorized in the state plan.
Approval Date: March 26, 2021
Effective Date: March 1, 2021
Topics: Disaster Relief Financing & Reimbursement

Massachusetts
This is an amendment to rates for nursing facilities and establishes additional payment methodologies associated with COVID-19 supports and oversights for fiscal year 2021.
Approval Date: March 26, 2021
Effective Date: October 1, 2020
Topics: Financing & Reimbursement

Hawaii
Effective January 13, 2021, this amendment increases the component prices for private nursing facility rates by 12 percent. 
Approval Date: March 25, 2021
Effective Date: January 13, 2021
Topics: Financing & Reimbursement

Guam
Effective January 1, 2021, this amendment revises Guam's skilled nursing facility rate methodology. 
Approval Date: March 25, 2021
Effective Date: January 1, 2021
Topics: Financing & Reimbursement

Kansas
Effective March 1, 2021, this amendment updates the early and periodic screening, diagnostic, and treatment (EPSDT) fee schedule to add reimbursement rates for cranial remolding helmets. 
Approval Date: March 25, 2021
Effective Date: March 1, 2021
Topics: Financing & Reimbursement