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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 2221 - 2230 of 15755

New Hampshire
The state adds the target group of 0 through age 5 and clarifies needs-based criteria language to the High-Risk Children with SED HCBS benefit.
Approval Date: June 23, 2023
Effective Date: July 1, 2023
Topics: Home and community based services

Idaho
This SPA implements a health home for Medicaid beneficiaries with intellectual disabilities and a diagnosis of serious mental illness or autism.
Approval Date: June 23, 2023
Effective Date: January 1, 2024
Topics: Health Homes Medicaid and CHIP Program (MACPro)

Virgin Islands
This SPA provides the United States Virgin Islands with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Approval Date: June 23, 2023
Effective Date: October 1, 2022

Vermont
This amendment proposes to update the coverage description and prior authorization policies for transplantation services.
Approval Date: June 23, 2023
Effective Date: May 1, 2023
Topics: Coverage Prior Authorization

Vermont

This amendment proposes to update the coverage description and prior authorization policies for transplantation services.

Approval Date: June 23, 2023
Effective Date: May 1, 2023
Topics: Coverage Prior Authorization Program Administration

West Virginia

This SPA proposes to modify language on the Pharmacy coverage pages to reflect coverage of selective over-the-counter (OTC) medications.

Approval Date: June 22, 2023
Effective Date: January 1, 2023
Topics: Coverage Prescribed Drugs

Texas
The proposed amendment updates the physicians’ and other practitioners’ fee schedules.
Approval Date: June 22, 2023
Effective Date: September 1, 2022

Massachusetts
This amendment proposes rate year (RY) 2023 supplemental payments to privately-owned psychiatric hospitals for COVID related services provided in DMH-approved Dedicated COVID psychiatric Units.
Approval Date: June 22, 2023
Effective Date: February 8, 2023

Nevada
This amendment revises your Disproportionate Share Hospital payment methodology.
Approval Date: June 22, 2023
Effective Date: January 20, 2023

Massachusetts
This plan amendment updates the methods and standards used to set payment rates for acute outpatient hospitals.
Approval Date: June 22, 2023
Effective Date: January 1, 2023