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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 2201 - 2210 of 15693

Guam
This amendment clarifies the assurance that Guam provides EPSDT services pursuant to sections 1902(a)(10)(A), 1905(a)(4)(B), and 1905(r) of the Social Security Act.
Approval Date: June 20, 2023
Effective Date: January 1, 2023

Utah
The purpose of this SP A is to provide language to facilitate reimbursement for pharmacist cognitive services such as MTM services and contraceptive prescribing.
Approval Date: June 20, 2023
Effective Date: January 1, 2023

Michigan
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 20, 2023
Effective Date: January 1, 2023

Ohio

To adopt new income and resource disregards, authorized under section 1902(r)(2)(A) of the Social Security Act, for the eligibility determinations of the non-MAGI groups covered under the state plan.

Approval Date: June 20, 2023
Effective Date: April 1, 2023

Maine
This BHH SPA amendment updates the reimbursement plan pages to identify two distinct PMPM rates: an adult PMPM rate and a child PMPM rate. This was due to in part a recently completed rate study performed by a contracted vendor for MaineCare Rate System Reform codification.
Approval Date: June 20, 2023
Effective Date: January 1, 2023
Topics: Health Homes Reimbursement

Wisconsin
This SPA implements Wisconsin's yearly increase to hospital rates. Specifically, this SPA modifies the outpatient Enhanced Ambulatory Patient Grouping Reimbursement Methodology to create a new outpatient payment per visit add-on for outpatient dental services where deep sedation is provided.
Approval Date: June 16, 2023
Effective Date: January 1, 2023

Nevada
This SPA is to amend its 1915-state plan home and community-based services (HCBS) benefit.
Approval Date: June 16, 2023
Effective Date: March 29, 2023
Topics: Home and community based services

Kansas
This amendment add stand-alone vaccine counseling for EPSDT to the state plan. The SPA also adds a new section for Immunization Preventive Services, and revises Attachment 3.1-B, Section 13, to align it with Attachment 3.1-A, Section 13.
Approval Date: June 16, 2023
Effective Date: April 1, 2023
Topics: Coverage Reimbursement

Idaho
This amendment renews Idaho’s1915(i) State Plan HCBS for Adults with Developmental Disabilities (DD) benefit.
Approval Date: June 16, 2023
Effective Date: July 1, 2023
Topics: Home and community based services

New Jersey
This SPA provides an add-on payment for General Acute Care Critical Se1vice for Pediatric pateints who are 20 yeai·s old or younger
Approval Date: June 16, 2023
Effective Date: January 1, 2023