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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 5581 - 5590 of 15843

Vermont
Eliminates the co-payments for preventive dental services
Approval Date: June 25, 2020
Effective Date: January 1, 2020
Topics: Dental Individual CoPayments or Insurance Payments

Missouri
SPA was submitted to request a waiver of the regulatory requirement at 42 CFR 455, Subpart F to enter into a contract with a Medicaid Recovery AuditContractor (RAC) vendor to identify overpayments and underpayments and to recoup overpayments.
Approval Date: June 25, 2020
Effective Date: April 1, 2020
Topics: Current State Plan Program Administration

Maine
Adds provisions for fiscal years 2020 and 2021 fourth quarter supplemental payments to qualifying nursing facilities that
provide comprehensive care to serve veteran’s unique needs
Approval Date: June 24, 2020
Effective Date: April 1, 2020
Topics: Financing & Reimbursement Veteran Homes

Maine
Adds the Rural Hospital and Non-Rural Hospital definitions and updates hospital-based physician
reimbursement.
Approval Date: June 24, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Wisconsin
Modifies inpatient and outpatient reimbursement rates,including for critical care supplements, wage area adjustment indices for border status hospitals, cost-to-charge ratios, and outpatient access payments effective January 1, 2020
Approval Date: June 24, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Massachusetts
This plan amendment updates the payment methods used to determine rates of payment for outpatient
psychiatric rates.
Approval Date: June 24, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Massachusetts
Amends the Methods Used to Determine Rates of Payment for Vision Services
Approval Date: June 24, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Maine
Adds provisions for two legislatively mandated special supplemental wage allowances for nursing facilities services
 
Approval Date: June 24, 2020
Effective Date: April 1, 2020

Pennsylvania
Authorizes a supplemental payment to qualifying inpatient hospitals operating nursing schools
Approval Date: June 24, 2020
Effective Date: April 19, 2020
Topics: Current State Plan Financing & Reimbursement

Oklahoma
Separates and differentiates between services provided in a school setting under EPSDT versus those school-based services provided pursuant to an Individual Education Plan (IEP).
Approval Date: June 24, 2020
Effective Date: September 1, 2020
Topics: Benefits Current State Plan Program Administration