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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 581 - 590 of 15689

New Hampshire

This plan amendment updates the nursing facility reimbursement rate budget adjustment factor and the Class Line 504 amount, effective July 1, 2024. This amendment also updates the plan language to refer to Patient Driven Payment Model (PDPM) for purpose of the case mix calculation.

Approval Date: October 15, 2024
Effective Date: July 1, 2024

New Hampshire

This plan amendment authorizes the critical access hospital inpatient supplemental payments for the state fiscal year ending June 30, 2025.

Approval Date: October 15, 2024
Effective Date: July 1, 2024

Nebraska

This amendment allows physician assistants to prescribe physical therapy, occupational therapy, and services for speech, hearing, and language disorders in the clinic, with both physician assistants and advanced practice registered nurses being able to prescribe these in the home setting.

Approval Date: October 11, 2024
Effective Date: July 1, 2024

Iowa

This plan amendment implements several provider rate increases.

Approval Date: October 11, 2024
Effective Date: July 1, 2024

Missouri

This plan amendment establishes reimbursement methodology for Behavioral Health Integration Services.

Approval Date: October 11, 2024
Effective Date: May 1, 2024

South Dakota

SPA implements an inflationary increase to the Health Home Per Member Per Month and Clinical Outcome Measure payment rates as appropriated by the state legislature during the 2024 legislative session effective July 1, 2024 and assures that the requirements for general and annual reporting of child and adult core sets are met.

Approval Date: October 11, 2024
Effective Date: July 1, 2024
Topics: Medicaid and CHIP Program (MACPro)

Louisiana

This SPA provides assurance in Attachment D that the benefit package provided for all individuals through the postpartum extension complies with section 1937 of the Act, including the provision of essential health benefits (EHBs) and that no treatment limitations that are more restrictive than the Alternative Benefit Plan (ABP).

Approval Date: October 9, 2024
Effective Date: July 1, 2024
Topics: Alternative Benefit Plan

Virginia

This plan amendment revises the reimbursement methodologies for Psychiatric Residential Treatment Facilities (PRTF) and hospital supplement payments for freestanding children's hospitals with greater than fifty percent Medicaid utilization.

Approval Date: October 9, 2024
Effective Date: July 1, 2024

Washington

This plan amendment clarified the language and payment methodology for Rehabilitative/Behavioral Health Services.

Approval Date: October 9, 2024
Effective Date: July 1, 2024

Colorado

This plan amendment updates the plan by making adjustments to the All Patient Refined-Diagnosis Related Group (APR-DRG) to align with Version 40.

Approval Date: October 9, 2024
Effective Date: October 1, 2024