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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 2201 - 2210 of 15690

Utah
The purpose of this SP A is to provide language to facilitate reimbursement for pharmacist cognitive services such as MTM services and contraceptive prescribing.
Approval Date: June 20, 2023
Effective Date: January 1, 2023

Maine
This BHH SPA amendment updates the reimbursement plan pages to identify two distinct PMPM rates: an adult PMPM rate and a child PMPM rate. This was due to in part a recently completed rate study performed by a contracted vendor for MaineCare Rate System Reform codification.
Approval Date: June 20, 2023
Effective Date: January 1, 2023
Topics: Health Homes Reimbursement

Michigan
Provides an update to the TCM State Plan Amendment C (aging) changing references of “in person” to “face to face” as face-to-face encompasses both in-person and telehealth which allows for more flexibility to assist individuals eligible under the State Plan.
Approval Date: June 16, 2023
Effective Date: May 12, 2023
Topics: Targeted Case Management

Maryland
To reimburse for community violence prevention services. Coverage will be extending to this service at a fee-for-service rate of $32.76 per 30-minute increments up to a maximum of 100 increments in a rolling 12-month period.
Approval Date: June 16, 2023
Effective Date: July 1, 2023
Topics: Coverage Reimbursement

West Virginia
To update qualifications for personal care service providers.
Approval Date: June 16, 2023
Effective Date: January 1, 2023

Virgin Islands

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 16, 2023
Effective Date: January 1, 2023

Michigan
To align the ABP with the state plan for coverage of dental services.
Approval Date: June 16, 2023
Effective Date: April 1, 2023

Kansas
This amendment add stand-alone vaccine counseling for EPSDT to the state plan. The SPA also adds a new section for Immunization Preventive Services, and revises Attachment 3.1-B, Section 13, to align it with Attachment 3.1-A, Section 13.
Approval Date: June 16, 2023
Effective Date: April 1, 2023
Topics: Coverage Reimbursement

Idaho
This amendment renews Idaho’s1915(i) State Plan HCBS for Adults with Developmental Disabilities (DD) benefit.
Approval Date: June 16, 2023
Effective Date: July 1, 2023
Topics: Home and community based services

Wisconsin
This SPA implements Wisconsin's yearly increase to hospital rates. Specifically, this SPA modifies the outpatient Enhanced Ambulatory Patient Grouping Reimbursement Methodology to create a new outpatient payment per visit add-on for outpatient dental services where deep sedation is provided.
Approval Date: June 16, 2023
Effective Date: January 1, 2023