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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 2261 - 2270 of 15689

Ohio
Updates post-eligibility treatment of income exclusions in accordance with the Stephen Beck Jr. Achieving a Better Life Experience (ABLE) Act and recently passed State legislation.
Approval Date: June 9, 2023
Effective Date: January 1, 2023

Louisiana
This SPA is to amend the provisions governing adult dentures services in order to link reimbursement rates to the Louisiana Medicaid fee schedule.
Approval Date: June 9, 2023
Effective Date: May 20, 2023
Topics: Coverage and Reimbursement

Michigan
This plan amendment allows payment for qualifying audio-only telemedicine visits.
Approval Date: June 8, 2023
Effective Date: May 12, 2023

Puerto Rico
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 7, 2023
Effective Date: January 1, 2023

Louisiana
This SPA is to amend the provisions governing the Home Health Program in order to increase the number of medical professionals that can order home health services.
Approval Date: June 7, 2023
Effective Date: May 20, 2023

Oregon

This SPA has been submitted to reflect reimbursement for Clotting Factor from Specialty Pharmacies.

Approval Date: June 6, 2023
Effective Date: March 7, 2023
Topics: Blood Clotting Drugs Prescribed Drugs Reimbursement

New York
This State Plan Amendment increases the inpatient hospital per-diem rate of reimbursement for extended observation bed (EOB) services in hospital-based comprehensive psychiatric emergency programs (CPEP), subsequent to a CPEP full or triage and referral visit and where the beneficiary remains in the CPEP for longer than 24 hours.
Approval Date: June 6, 2023
Effective Date: July 1, 2022

North Carolina
This State Plan change will allow Medicaid to reimburse for Opioid Treatment Program (OTP) services provided to individuals with an Opioid Use Disorder. OTP services are being revised to allow for a bundled payment consistent with Medicare rates that utilizes an integrated service model that includes medication, medication administration, counseling, laboratory tests and case management services.
Approval Date: June 6, 2023
Effective Date: April 1, 2023

Georgia
This State Plan Amendment updates Nursing Home reimbursement rates to the 2020 nursing home cost reports. The SPA also updates calculation of the Property and Related Net Per Diem established under the FRV System by increasing the rate for construction cost for nursing facilities from $187.12 to 198.86, as derived from the 2020 RSMeans Building Construction cost data for Nursing Homes.
Approval Date: June 6, 2023
Effective Date: July 1, 2022

Massachusetts
The state proposed 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 6, 2023
Effective Date: January 1, 2023