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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 1931 - 1940 of 15693

Alabama

This SPA proposes to update the state's Excluded Drug list, to include amending the language provisions for coverage of selective non-prescription covered outpatient drugs.

Approval Date: September 7, 2023
Effective Date: June 1, 2023
Topics: Prescribed Drugs Reimbursement

Michigan

This SPA provides authority to cover and to reimburse for Psychiatric Residential Treatment Facility (PRTF) services for eligible Michigan Medicaid beneficiaries.

Approval Date: September 7, 2023
Effective Date: December 1, 2023

Oregon

To increase the rate for NEMT mileage, meals, and lodging and base them on a percentage of the IRS standard rates.

Approval Date: September 6, 2023
Effective Date: April 1, 2023

West Virginia

This state plan amendment clarifies coverage of crisis intervention services and service rates.

Approval Date: September 5, 2023
Effective Date: July 1, 2023
Topics: Benefits Reimbursement

Oklahoma

This amendment proposes to add secure mental health transportation services to Oklahoma’s Medicaid State Plan.

Approval Date: September 5, 2023
Effective Date: July 1, 2023
Topics: Coverage Reimbursement Transportation

New Hampshire

Effective May 30, 2023, this amendment provides for coverage and reimbursement for psychiatric residential treatment facility (PRTF) services.

Approval Date: September 5, 2023
Effective Date: May 30, 2023

Colorado

Effective for services on or after July 1, 2023, this amendment provides for a two percent inflationary increase to the per diem rates for both Specialty-Acute and Rehabilitation hospitals.

Approval Date: September 1, 2023
Effective Date: July 1, 2023

Vermont

This amendment establishes Vermont’s ability to enter into value-based supplemental rebate agreements with drug manufacturers.

Approval Date: September 1, 2023
Effective Date: April 1, 2023
Topics: Additional Rebate Covered Outpatient Drug Prescription Drugs Supplemental Rebates and Managed Care Value Based Purchasing

Tennessee

This amendment is submitted to add lactation services and the Advisory Committee on Immunization Practices (ACIP) adult vaccine assurance to the preventive services benefit.

Approval Date: September 1, 2023
Effective Date: June 1, 2023
Topics: Benefits Preventative Services Vaccine

Louisiana

This amendment grants an extension of the exception from participation in the Recovery Audit Contractor (RAC) Program.

Approval Date: August 31, 2023
Effective Date: August 6, 2023
Topics: Benefits Program Administration