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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 3671 - 3680 of 15708

Wisconsin
This amendment provides attestation to coverage of usual and customary care for Wisconsin Medicaid beneficiaries participating in clinical trials as required by the Consolidated Appropriations Act of 2021 Effective January 1, 2022.
Approval Date: April 25, 2022
Effective Date: January 1, 2022

Arkansas
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to authorize lump sum payments to State plan HCBS providers for services provided during the PHE, as described in Arkansas’ approved Section 9817 spending plan.
Approval Date: April 22, 2022
Effective Date: October 1, 2021
Topics: Disaster Relief Reimbursement

Montana
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to temporarily adjust staffing requirements, including staffing structure and required number of team members, for Montana Assertive Community Treatment and Program of Assertive Community Treatment to ensure services remain available.
Approval Date: April 22, 2022
Effective Date: July 1, 2020
Topics: Benefits Disaster Relief

North Dakota
The purpose of this amendment is to amend the State Plan to assure coverage of items and services furnished in connection with a qualified clinical trial.
Approval Date: April 22, 2022
Effective Date: January 1, 2022
Topics: Benefits Reimbursement

Virginia
Proposes to add coverage for Virginia’s Alternative Benefit Plan Medicaid Expansion, Routine Patient Cost in Qualifying Clinical Trials.
Approval Date: April 21, 2022
Effective Date: January 1, 2022
Topics: Alternative Benefit Plan

Virginia
To add coverage for Virginia’s Alternative Benefit Plan Medicaid Works, Routine Patient Cost in Qualifying Clinical Trials.
Approval Date: April 21, 2022
Effective Date: January 1, 2022
Topics: Alternative Benefit Plan

California
Exempts Durable Medical Equipment (DME) Complex Rehabilitation Technology (CRT) and Complex Rehabilitation Technology Services (CRTS) from the ten percent payment reductions.
Approval Date: April 21, 2022
Effective Date: January 1, 2022
Topics: Financing & Reimbursement

Ohio
Payment for Services: Non-Institutional Payment Schedule, Behavioral Health E&M codes Updates for 2022.
Approval Date: April 21, 2022
Effective Date: January 1, 2022
Topics: Financing & Reimbursement

Maine
SPA was submitted in order to implement Maine’s Primary Care Plus (PCPlus) Program, intended to replace the three existing primary care programs in the state with a single simplified and integrated program.
Approval Date: April 21, 2022
Effective Date: July 1, 2022

Louisiana
This SPA amended the provisions governing Rural Health Clinics (RHCs) in order to establish that where payment(s) from managed care organizations (MCOs) are less than the amount the RHC would be entitled to receive under the Prospective Payment System (PPS) or alternative payment methodology (APM), the RHC will be eligible to receive a wrap-around supplemental payment processed and paid by the Louisiana Department of Health.
Approval Date: April 21, 2022
Effective Date: January 27, 2022