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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 2031 - 2040 of 15692

Alaska
CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency.  The purpose of this amendment is to temporarily extend the suspension of behavioral health prior/service authorizations for one year after the end of the COVID-19 Public Health Emergency (PHE). This extension was authorized under the authority of an 1135 blanket waiver on 4.2.20. The TE extension is necessary to aid Alaska's return to routine operations.
Approval Date: July 28, 2023
Effective Date: May 12, 2023
Topics: Benefits Disaster Relief

Louisiana
CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency.  The purpose of this amendment is to extend the disaster relief provisions governing preventive services in order to reimburse ambulance service providers who provide allowable services on site, without transport, while under the supervision of a licensed physician.
Approval Date: July 28, 2023
Effective Date: May 12, 2023
Topics: Disaster Relief Reimbursement

Colorado
Updates the Alternative Payment Model (APM) section by increasing the partial prospective payment rate 16% for all Principal Accountable Providers (PAP) that receive 25% or more of their reimbursement through the APM 2.
Approval Date: July 28, 2023
Effective Date: July 1, 2023

Alaska
This State Plan Amendment implements a payment rate for providers of Home and Community Based Services adopting a 10% increase for all HCBS (including waiver) services.
Approval Date: July 28, 2023
Effective Date: June 26, 2023

Mississippi
Allows the Division of Medicaid (DOM) to continue the same PDN rates.
Approval Date: July 28, 2023
Effective Date: May 12, 2023

Mississippi
This plan amendment was submitted to allow the Division of Medicaid (DOM) to continue the fifteen percent (15%) increase for Prescribed Pediatric Extended Care (PPEC) facilities that were made effective October 1, 2022 beyond the end of the federal Public Health Emergency.
Approval Date: July 28, 2023
Effective Date: May 12, 2023

North Carolina
The state proposed to: transition its separate NC Health Choice Children's Health Insurance Program to the NC Medicaid Program; adopt a new Medicaid eligibility group for certain children under age 19; and align the income standard for all children under age 19 at 211 percent of the federal poverty level.
Approval Date: July 28, 2023
Effective Date: April 1, 2023

Vermont
The state submitted this SPA to align its ABP with previously approved SPAs 23-0017, 23-0023, and 23-0027 regarding dental therapists, podiatry services and prior authorization policies for prosthetic devices.
Approval Date: July 28, 2023
Effective Date: May 1, 2023
Topics: ABP Prior Authorization

South Dakota

This amendment extends the supplemental payments for qualifying, private hospitals and nursing facilities for an additional state fiscal year.

Approval Date: July 28, 2023
Effective Date: May 1, 2023

Hawaii
This amendment is to waive the provider application fee.
Approval Date: July 27, 2023
Effective Date: May 18, 2023
Topics: Program Administration