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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 1001 - 1010 of 15819

New Hampshire

This State Plan Amendment allows for a 3.1% increase to Prosthetic Devices, Durable Medical Equipment, Supplies, and Eyeglasses.

Approval Date: June 25, 2024
Effective Date: January 1, 2024
Topics: Rebate/Reimbursement Updates

Kentucky

This SPA updates changes regarding repackaging fees, pricing logic, and the professional dispensing fee for compounded drugs.

Approval Date: June 25, 2024
Effective Date: April 1, 2024
Topics: Professional Dispensing Fee Reimbursement

Illinois

This SPA proposes to increase Graduate Medical Education (GME) payments to freestanding children’s hospitals.

Approval Date: June 24, 2024
Effective Date: April 1, 2024

Michigan

This plan amendment extends the MIDocs Consortium within the State of Michigan’s Graduate Medical Education (GME) Innovations Sponsoring Institution Program through Fiscal Year 2024

Approval Date: June 24, 2024
Effective Date: April 1, 2024

Washington

This plan amendment updated the fee schedule effective dates for several Medicaid services.

Approval Date: June 24, 2024
Effective Date: April 1, 2024

Nevada

This amendment is the addition of a licensed behavior analysts, licensed assistant behavior analysts and registered behavior technicians within their scope of practice according to state law.

Approval Date: June 21, 2024
Effective Date: April 1, 2024

Michigan

To disregard, under the authority of section 1902(r)(2) of the Social Security Act, assistance received from guaranteed income programs.

Approval Date: June 21, 2024
Effective Date: January 1, 2024

Montana

This plan amendment updates the outpatient hospital services fee schedule, increases the conversion factor for outpatient hospital services, and amends the Medicaid statewide average outpatient hospital cost-to-charge ratio.

Approval Date: June 21, 2024
Effective Date: July 1, 2024

Oregon

This plan amendment added the new procedure code for opioid overdose reversal drugs to the state-wide fee schedule.

Approval Date: June 21, 2024
Effective Date: January 4, 2024

Utah

This SPA proposes to clarify the reimbursement for certain provider administered drugs.

Approval Date: June 21, 2024
Effective Date: February 26, 2024
Topics: Covered Outpatient Drug Physician Administered Drugs Prescribed Drugs Prescription Drugs Reimbursement