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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 6121 - 6130 of 15843

Ohio
Recovery Audit Contractor Exception 2020
 
Approval Date: December 18, 2019
Effective Date: January 1, 2020
Topics: Current State Plan Program Administration

Iowa

Increases available services to members on the basic benefit package. In particular, denture related services were added. During the SFY19 it was revealed that members with dentures in the basic benefit tier did not have access to the needed services.

Approval Date: December 18, 2019
Effective Date: August 30, 2019

Minnesota

This amendment to the MInnesota Medicaid state plan:

  • Reduces the rate to reflect the change in the MinnesotaCare provider tax on January 1,2020.
  • Adds a policy adjustment factor for specialty mental health services, and revises the policy adjustment factor for: burns; pre-major diagnostic category; transplants; and trauma.
  • Revises the charge limit.
  • Revises the base year to 2016 for hospital costs.
Approval Date: December 18, 2019
Effective Date: July 1, 2019
Topics: Program Administration

Wisconsin
Amends methods of Implementation for Nursing Home Payment Rates
Approval Date: December 18, 2019
Effective Date: July 1, 2019
Topics: Program Administration

Massachusetts
Transportation rates.
Approval Date: December 17, 2019
Effective Date: September 23, 2019
Topics: Financing & Reimbursement

New Mexico
Describes the organization of New Mexico's Single state Agency, the New Mexico Department of Human Services, and the administration of the state's Medicaid
program
Approval Date: December 17, 2019
Effective Date: July 1, 2019
Topics: Program Administration

New York
Revises the State Plan to add Applied Behavioral analyst, certified behavior analyst assists under the supervision of licensed behavior analyst, or other individual specified under article one hundred sixty-seven of New York State education law, and update service type/fee schedule accordingly
Approval Date: December 17, 2019
Effective Date: October 1, 2019

Colorado
Adds an Alternative Payment Model (APM) to the Physician Service reimbursement page in Attachment 4. 19- 13: Methods and Standards for
Establishing Payment Rates
Approval Date: December 17, 2019
Effective Date: October 1, 2019
Topics: Financing & Reimbursement

Connecticut
incorporates various Healthcare Common Procedure Coding System (HCPCS) updates to the Physician Office & Outpatient, Physician-Radiology, Physician-Surgery, Psychology and Autism Spectrum Disorder Services fee schedules. In accordance with section 12 of Attachment 4.19-B of the State Plan, this SPA also updates the
physician fee schedule and incorporates the required annual update for reimbursement of physician administered drugs, immune globulins, vaccines and toxoids.
Approval Date: December 17, 2019
Effective Date: January 1, 2019
Topics: Financing & Reimbursement

Colorado
modifies the reimbursement methodology for long-acting reversible contraceptive ( LARC) devices, inserted following delivery, in an inpatient hospital setting.
Approval Date: December 17, 2019
Effective Date: January 1, 2019
Topics: Financing & Reimbursement