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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 1461 - 1470 of 15693

Nevada

The purpose of this SPA is to implement an auto-assignment algorithm to reflect MCO enrollment assignment ranking based on quality measure performance.

Approval Date: January 11, 2024
Effective Date: January 1, 2024

Louisiana

The purpose of this SPA is to amend the provisions governing the Pharmacy Benefits Management program in order to remove references to specific over-the-counter (OTC) drugs that are covered under the State Plan.

Approval Date: January 11, 2024
Effective Date: December 20, 2023
Topics: Coverage Prescribed Drugs

Nevada

This SPA updates the payment methodology for personal care services.

Approval Date: January 11, 2024
Effective Date: January 1, 2024

North Dakota

This state plan amendment will supersede SPA ND-23-0020 and updates reimbursement for in-state PPS outpatient hospital services to the Enhanced Ambulatory Patient Group (EAPG) payment system.

Approval Date: January 10, 2024
Effective Date: October 1, 2023

Vermont

This amendment proposes to assure coverage of adult vaccines per the Inflation Reduction Act and coverage of preventive services.

Approval Date: January 9, 2024
Effective Date: October 1, 2023

Illinois

This SPA updates Illinois' Medicaid State Plan to comply with third party liability (TPL) requirements authorized under the Bipartisan Budget Act of 2018 and the Consolidated Appropriations Act of 2021.

Approval Date: January 8, 2024
Effective Date: July 1, 2023

District of Columbia

This plan amendment to update rates for Mental Health Rehabilitative Services and Adult Substance Use Rehabilitative Services.

Approval Date: January 8, 2024
Effective Date: October 1, 2023

Colorado

This plan amendment adds authority for the state to negotiate higher reimbursement rates with certain out of state providers.

Approval Date: January 6, 2024
Effective Date: December 1, 2024

Pennsylvania

This plan amendment authorizes the Department to make an additional payment to nonpublic and county nursing facilities that qualified for supplemental ventilator care and tracheostomy care payments in a city of the first class.

Approval Date: January 6, 2024
Effective Date: October 1, 2024

Iowa

State is reducing the income eligibility standard for certain pregnant women and infants.

Approval Date: January 6, 2024
Effective Date: January 1, 2025