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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 1541 - 1550 of 15693

Louisiana

The purpose of this SPA is to amend the provisions governing disproportionate share hospital (DSH) payments to increase reimbursement for DSH eligible services provided by hospitals through a cooperative endeavor agreement with the Office of Behavioral Health(OBH), in order to align the rate for OBH approved DSH days with the Medicaid inpatient psychiatric per diem rate on file for freestanding psychiatric hospitals.

Approval Date: December 13, 2023
Effective Date: December 1, 2023

Rhode Island

On September 20, 2023, CMS received Rhode Island State Amendment RI-23-0010 for CEDAR Health Homes. EOHHS is seeking approval from CMS to update Rhode Island’s Medicaid State Plan to implement a change in the rate methodology for Cedar Family Centers.

Approval Date: December 13, 2023
Effective Date: July 1, 2023

New York

This plan proposes a minimum wage adjustment for clinics.

Approval Date: December 12, 2023
Effective Date: January 1, 2022

New York

This plan proposes updates to remove the “Behavioral Health Utilization Controls” payment reductions for clinics.

Approval Date: December 12, 2023
Effective Date: July 1, 2022

New York

To transition the New York State Medicaid non-emergency medical transportation (NEMT) program from an administrative- services only model to a risk-based broker model authorized pursuant to Section 1902(a)(70) of the Social Security Act.

Approval Date: December 12, 2023
Effective Date: August 1, 2023

New York

To revise the State Plan to expand coverage of store and forward services for the purposes of strengthening and sustaining telehealth as a high-quality, cost effective, and consumer-oriented form of care delivery.
 

Approval Date: December 12, 2023
Effective Date: April 1, 2023
Topics: Coverage and Reimbursement

Ohio

Pursuant to state legislation that rescinds Medicaid coverage and payment provisions for outpatient health facilities (OHF), this SPA proposes to remove the obsolete Attachment 3.1-A and 4.19-B pages from the Medicaid State Plan.

Approval Date: December 12, 2023
Effective Date: February 1, 2024

Texas

The purpose of the amendment is to clarify the reimbursement methodology for renal dialysis services as payable outside of the current composite rate due to new and/or expensive technology and high cost drugs.

Approval Date: December 12, 2023
Effective Date: July 1, 2023

New York

This plan proposes updates to Ambulatory Patient Group (APG) rates for freestanding clinics and reimbursement for Licensed Mental Health Counselors (LMHCs) services and Licensed Marriage and Family Therapists (LMFTs) services.

Approval Date: December 12, 2023
Effective Date: July 1, 2023

Iowa

This Plan revises the new name of the single state agency to reflect Iowa Department of Health and Human Services.

Approval Date: December 11, 2023
Effective Date: July 1, 2023
Topics: Medicaid and CHIP Program (MACPro)