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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.

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Showing 2071 to 2080 of 2090 results
Transmittal Number: SC-20-0008
State: South Carolina
Summary: This SPA includes reimbursement methods that use, among others, the National Average Drug Acquisition Cost (NADAC), plus a professional dispensing fee of $10.50 for covered outpatient drugs. This SPA also includes reimbursement rates for 340B drugs, long-term care and specialty drugs, drugs purchased at a nominal price, and physician administered drugs.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
  • Covered Outpatient Drug
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: FL-20-0004
State: Florida
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to update the State Plan to include emergency provisions including: suspension of co-payments, adjust current benefits, expand telemedicine services, increase payment rates, eliminate sanctions for cost reports, and modify occupancy limits.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Cost Sharing
  • Benefits
  • Prescription Drugs
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: ND-20-0030
State: North Dakota
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to allow the state to waive the 24 day limit for payment for a reserved day for therapeutic leave of absences for a resident of a nursing facility.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NY-20-0051
State: New York
Summary: Across the board reduction 1.5% - IP (FMAP=50%)
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: CT-20-0018
State: Connecticut
Summary: amends reimbursement for inpatient hospital services for State Fiscal Year (SFY) 2021.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: KS-20-0016
State: Kansas
Summary: Sets the rate for cytogenomic microarray (CMA) testing at 85% of the non-rural Medicare rate as set on January 1 each year.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: IL-20-0010
State: Illinois
Summary: Increase rates of reimbursement for mental health and substance use disorder services.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
  • Program Administration
Links:
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Transmittal Number: DC-20-0005
State: District of Columbia
Summary: updates the Medicaid fee schedule to add reimbursement for medical alert devices under state plan home health benefit
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NC-20-0009
State: North Carolina
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. This second Medicaid Disaster Relief SPA for North Carolina includes temporary modifications to benefit and payment provisions during the emergency declaration period. The state is proposing the following temporary rate increases: 1) a 10% rate increase for certain providers facing a disproportionate impact during the pandemic, 2) a 5% general increase to all providers that have not yet received one as required by the State’s General Assembly, and 3) authority to provide payments to pharmacy providers for mail-prescriptions to reduce direct contact for beneficiaries and providers.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Eligibility
  • Benefits
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: CT-20-0015
State: Connecticut
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing, expand coverage to certain 1915, 1915(k), home health, laboratory and telehealth services, adjust prior authorizations for medications, and increase certain payment rates.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Benefits
  • Prescription Drugs
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT