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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 2081 - 2090 of 15690

Georgia
This plan amendment eliminates attestation requirements and increases rates for Obstetrics/Gynecology (OB/GYN).
Approval Date: July 12, 2023
Effective Date: July 1, 2022

Maine
This amendment proposes to extend Maine’s previously granted Recovery Audit Contractor (RAC) program exception from June 1, 2023, to June1, 2025
Approval Date: July 12, 2023
Effective Date: June 1, 2023
Topics: Program Administration

Georgia

This amendment is to add the Pathways beneficiaries as a mandatory population enrolled in managed care.

Approval Date: July 12, 2023
Effective Date: July 1, 2023

North Carolina
This plan amendment proposes to set the rates for telehealth audio-only codes 99441, 99442 and 99443 at 86 percent of the 2022 Medicare Resource-Based Relative Value Scale (RBRVS) physician fee schedule (PFS).
Approval Date: July 11, 2023
Effective Date: May 12, 2023

Kansas
Due to passage of legislation during the 2023 legislature session, select emergency transportation reimbursement rates have been increased.
Approval Date: July 11, 2023
Effective Date: July 1, 2023

Kansas
The SPA increases the DMEPOS reimbursement rates to 80% of Medicare. The SPA will also add self-monitoring blood pressure (BP) devices to the DME list for pregnant women at risk for gestational hypertension, and for persons with heart failure or end-stage renal disease (ESRD).
Approval Date: July 11, 2023
Effective Date: July 1, 2023

Kansas
This plan amendment increases the global pregnancy services provider reimbursement rates.
Approval Date: July 11, 2023
Effective Date: July 1, 2023

Oklahoma
This amendment authorizes the administration of immunizations recommended by the Advisory Committee on Immunization Practices (ACIP) by licensed pharmacies, pharmacists, pharmacy interns, and pharmacy technicians
Approval Date: July 11, 2023
Effective Date: May 12, 2023
Topics: Coverage and Reimbursement

Rhode Island
EOHHS is proposing to submit an amendment to the Medicaid State Plan. This amendment will codify the cost-based payment method for Psychiatric Residential Treatment Facilities (PRTF).
Approval Date: July 10, 2023
Effective Date: April 1, 2021

North Carolina
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 flexibilities related to Skilled Nursing Facilities, Personal Care Services, and Nitrous Oxide.
Approval Date: July 7, 2023
Effective Date: May 12, 2023
Topics: Benefits Disaster Relief