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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 551 - 560 of 15690

California

This amendment adds pharmacies as supervisors of Community Health Workers (CHWs).

Approval Date: October 25, 2024
Effective Date: October 1, 2024
Topics: Coverage Other Licensed Practitioners

Washington

This amendment updates Physician Assistant Services, Screening, Brief Intervention, Referral and Treatment Services Providers, and Collaborative Care Services Providers to the Medicaid State Plan.

Approval Date: October 25, 2024
Effective Date: January 1, 2025
Topics: Coverage Preventative Services

Northern Mariana Islands

This plan amendment increased the reimbursement rates for Durable Medical Equipment (DME).

Approval Date: October 24, 2024
Effective Date: July 1, 2024

Oregon

This amendment is to expand the Targeted Case Management Family Connects Nurse Home Visiting program into Polk and Yamhill County.

Approval Date: October 24, 2024
Effective Date: January 1, 2025
Topics: Targeted Case Management

Illinois

This amendment adds coverage for the human papillomavirus (HPV) vaccine for persons 46 years of age or older who meet certain medical criteria.

Approval Date: October 23, 2024
Effective Date: January 1, 2025

South Dakota

This amendment inflationary rate increases and various coverage and service updates.

Approval Date: October 23, 2024
Effective Date: July 1, 2024
Topics: Coverage and Reimbursement Eligibility

North Carolina

This plan amendment updates the per member per month health management fees for the Carolina ACCESS and Advanced Medical Home (AMH) Program.

Approval Date: October 23, 2024
Effective Date: July 1, 2024

Georgia

This amendment seeks to modify the reimbursement rates for community behavioral health services, add community health workers to the list of acceptable practitioners, and update the accreditation language.

Approval Date: October 23, 2024
Effective Date: July 1, 2024
Topics: Coverage Other Licensed Practitioners Reimbursement

Nevada

This State Plan Amendment is to define residential services for substance use treatment and expand the type of providers who can render services.

Approval Date: October 23, 2024
Effective Date: July 31, 2024
Topics: Coverage and Reimbursement

Oregon

This SPA increases the prescription drug professional dispensing fee.

Approval Date: October 22, 2024
Effective Date: November 1, 2024
Topics: Professional Dispensing Fee