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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.

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Showing 1611 to 1620 of 2110 results
Transmittal Number: NY-21-0036
State: New York
Summary: This plan amendment updates the Public General Hospital Outpatient Supplemental

Payment Adjustment for the state fiscal year beginning April 1, 2021 and ending March 31, 2022.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: NY-20-0022
State: New York
Summary: Effective April 1, 2020, this amendment continues UPL supplemental payments to public non-state government owned and operated hospitals for inpatient services in the amount of $334,056,330.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: IN-22-0012
State: Indiana
Summary: This State Plan Amendment (SPA) looks to provide Medicaid coverage for eligible members to receive general pediatric vaccine counseling as part of EPSDT. Beginning with dates of service on or after September 1, 2022, stand-alone general pediatric vaccination counseling as part of the early and periodic screening, diagnostic, and treatment (EPSDT) benefit will be reimbursed under CPT 99401 with modifier EP per the fee schedule. This SPA also relocates payment for Ambulance Response and Treat-no-Transport Services for Emergency Medical Technicians (EMT's) under the direction of a physician.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: NH-22-0040
State: New Hampshire
Summary: Updates the nursing facility reimbursement rate budget adjustment factor as well as the Class Line 504 amount.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: SC-22-0002
State: South Carolina
Summary: Updates ICF/IID rates effective Jan. 1, 2022 using the most recent cost report information available and updated trend factor.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: KY-22-0008
State: Kentucky
Summary: Changes to the intermediate care facility for individual s with an intellectual disability, dually-licensed pediatric fac ili ty, institution for mental diseases, or a nursing facility with an all-inclusive rate unit reimbursement language in its State Plan
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: CA-22-0032
State: California
Summary: This SPA amends the definition of a Targeted Case Management (TCM) encounter to include the provision of TCM services appropriately provided face-to-face, as well as through video synchronous and audio-only synchronous telehealth interactions.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: TX-22-0033
State: Texas
Summary: Updates the fee schedule for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) and Vision Care Services.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
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Transmittal Number: WV-22-0022
State: West Virginia
Summary: Ambulance Ground Transportation Rates Increased to 100% of Medicare
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: DE-22-0010
State: Delaware
Summary: Updates Delaware Medicaid State Plan Targeted Case Management (TCM) services to align provider qualifications and reimbursement.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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