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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 1031 - 1040 of 15696

District of Columbia

This plan amendment updates Medicaid reimbursement rates for physical therapy, occupational therapy, and speech-language therapy services under the home health benefit.

Approval Date: May 8, 2024
Effective Date: January 1, 2024

Iowa

This plan amendment implements the tri-annual outpatient hospital rate rebase.

Approval Date: May 8, 2024
Effective Date: January 3, 2024

Texas

This plan amendment updates the family planning services fee schedules.

Approval Date: May 8, 2024
Effective Date: April 1, 2024

Hawaii

This amendment is to add palliative care services in non-hospital settings.

Approval Date: May 7, 2024
Effective Date: January 1, 2023
Topics: Coverage and Reimbursement

Massachusetts

This amendment establishes a Coordinating, Aligned, Relationship-centered, Enhanced Support (CARES) Targeted Case Management (TCM) benefit for children.  This new CARES TCM will provide intensive support in care planning and coordination of services for eligible medically complex MassHealth members younger than 21.

Approval Date: May 7, 2024
Effective Date: July 1, 2023
Topics: Benefits Targeted Case Management

New Jersey

This SPA proposes to suspend the Medicaid Recovery Audit Contractor Program, a requirement in section 1902(a)(42)(B)(i) of the Social Security Act, for a two-year period because ninety-seven percent of Medicaid beneficiaries participate in managed care.

Approval Date: May 6, 2024
Effective Date: January 1, 2024
Topics: Program Administration

Nevada

This SPA provides Nevada with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.

Approval Date: May 3, 2024
Effective Date: January 1, 2024
Topics: Benefits Medicaid and CHIP Program (MACPro)

Washington

This SPA amends new income disregards for the Qualified Medicare Beneficiaries (QMB) and Qualifying Individuals eligibility groups.

Approval Date: May 3, 2024
Effective Date: April 1, 2024
Topics: Eligibility Medicaid and CHIP Program (MACPro)

Montana

Move authority for the Tribal Health Improvement Program (T-HIP) from a 1915(b) waiver to a 1932(a) SPA, while further aligning the program design with primary care case management entity requirements found in 42 CFR § 438.2.

Approval Date: May 3, 2024
Effective Date: July 1, 2024
Topics: Managed Care Tribal/Indian Health Services

Nevada

This plan amendment updates the updates the payment methodology for state plan Certified Community Behavioral Health Clinics (CCBHCs).

Approval Date: May 3, 2024
Effective Date: May 12, 2023