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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 2151 - 2160 of 15690

Massachusetts
Effective January 1, 2023 this amendment revises rate year (RY) 2023 reimbursement for privately-owned acute care hospital services. Specifically, it implements payment for: behavioral health crisis evaluation services; acute inpatient discharge add-on; and a Clinical Quality Incentive (CQI) program.
Approval Date: June 26, 2023
Effective Date: January 1, 2023

Massachusetts

This amendment looks to 1) update the coverage and payment methods and standards used by Massachusetts for psychologist services; and 2) to establish coverage and payment methods and standards used by Massachusetts for licensed independent clinical social worker services.

Approval Date: June 26, 2023
Effective Date: January 1, 2023
Topics: Coverage and Reimbursement Other Licensed Practitioners

Iowa
This amendment is to add covered services of functional family therapy and multisystemic therapy for youth.
Approval Date: June 23, 2023
Effective Date: March 1, 2023

Maryland
To adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Approval Date: June 23, 2023
Effective Date: January 1, 2023

Delaware
To adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Approval Date: June 23, 2023
Effective Date: January 1, 2023

New Hampshire
The state adds the target group of 0 through age 5 and clarifies needs-based criteria language to the High-Risk Children with SED HCBS benefit.
Approval Date: June 23, 2023
Effective Date: July 1, 2023
Topics: Home and community based services

Idaho
This SPA implements a health home for Medicaid beneficiaries with intellectual disabilities and a diagnosis of serious mental illness or autism.
Approval Date: June 23, 2023
Effective Date: January 1, 2024
Topics: Health Homes Medicaid and CHIP Program (MACPro)

Virgin Islands
This SPA provides the United States Virgin Islands with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Approval Date: June 23, 2023
Effective Date: October 1, 2022

Massachusetts
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to suspend all pharmacy copays for eligibility groups consistent with 42 CFR 435 Subparts B, C, and D. (Effective date 5/1/22 and through the duration of the federal public health emergency).
Approval Date: June 23, 2023
Effective Date: May 1, 2023
Topics: Disaster Relief Eligibility

New York
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to provide Reimbursement of antibody infusions.
Approval Date: June 23, 2023
Effective Date: June 24, 2021
Topics: Disaster Relief Reimbursement