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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 211 - 220 of 15690

North Carolina

This plan amendment adds language to clarify when hospital transfers qualify for outlier payments and includes a detailed list of applicable discharge status codes that determine payment eligibility.

Approval Date: January 14, 2025
Effective Date: December 1, 2024
Links:
    No links available
Topics: Reimbursement

Ohio

This plan amendment updates rates for changes of ownership in nursing facilities.

Approval Date: January 14, 2025
Effective Date: December 1, 2024

Pennsylvania

This plan amendment authorizes the Department to make an additional payment to nonpublic and county nursing facilities in a township of the first class in a county of the second class A.

Approval Date: January 14, 2025
Effective Date: October 1, 2024

Kansas

This plan amendment excludes select pharmaceuticals from the DRG reimbursement system.

Approval Date: January 14, 2025
Effective Date: October 18, 2024

Ohio

This plan amendment ends the Potentially Preventable Readmissions Program.

Approval Date: January 14, 2025
Effective Date: December 30, 2024

Nevada

This SPA is to update state plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.

Approval Date: January 14, 2025
Effective Date: December 19, 2024
Topics: Medicaid and CHIP Program (MACPro)

Louisiana

This plan amendment extends enhanced payments to private Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID), in order to allow more time to address the needs of private ICF/IID that still rely on this variance while continuing to provide services to the residents of these facilities.

Approval Date: January 14, 2025
Effective Date: January 1, 2025

Pennsylvania

This plan amendment authorizes the Department to make supplement payments to certain nonprofit nursing facilities in a city of the second class A in a county of the third class.

Approval Date: January 14, 2025
Effective Date: December 1, 2024

Pennsylvania

This plan amendment authorizes the Department to make supplement payments to certain nonpublic nursing facilities in a home rule county of the second class.

Approval Date: January 14, 2025
Effective Date: December 1, 2024

Indiana

This plan amendment equalizes rates for certain hospitals.

Approval Date: January 14, 2025
Effective Date: January 1, 2025