U.S. flag

An official website of the United States government

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 5101 - 5110 of 15777

New Mexico
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to implement targeted access supplemental payments for Safety-Net Care Pool (SNCP) hospitals.
Approval Date: December 17, 2020
Effective Date: April 1, 2020
Topics: Disaster Relief Reimbursement

Texas
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to reimburse ICF/IID(s) to reserve a bed for eligible residents during temporary leaves of absence taken to reduce the risk of COVID-19 transmission.
Approval Date: December 17, 2020
Effective Date: March 20, 2020
Topics: Disaster Relief Reimbursement

West Virginia
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to begin reimbursing enrolled Hospitals and Critical Access Hospitals for the use of Medicare certified swing beds and to adjust certain inpatient rates to allow for increased reimbursements.
Approval Date: December 17, 2020
Effective Date: March 1, 2020
Topics: Disaster Relief Reimbursement

Iowa
Updates the medical exemption process for the Iowa Health and Wellness Plan (IHAWP)
Approval Date: December 17, 2020
Effective Date: December 1, 2020
Topics: Program Administration

Colorado
Decreases the maximum adult dental benefit
Approval Date: December 17, 2020
Effective Date: April 1, 2021

Nevada
We have reviewed the proposed amendment to Attachment 4.19-D of your Medicaid state plan submitted under transmittal number (TN) 20-0014. Effective September 1, 2020, this state plan amendment changes reimbursement for certain intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs) to a cost reimbursement methodology. 
Approval Date: December 17, 2020
Effective Date: September 1, 2020
Topics: Financing & Reimbursement

Alabama
Proposes to amend the value/outcomes based agreement template in order to further facilitate obtaining supplemental rebates
Approval Date: December 17, 2020
Effective Date: December 1, 2020

North Carolina
This SPA proposes to add the provider’s gross amount due (GAD) to the reimbursement hierarchy for covered outpatient drugs.  This SPA also proposes to implement a new reimbursement methodology for Indian Health Services/Indian Tribal pharmacy facilities based on the OMB encounter rate, as well as adding a delivery payment for drugs delivery by mail, courier, or person-to-person.
Approval Date: December 17, 2020
Effective Date: September 1, 2020
Topics: Financing & Reimbursement

California
Adjusts the Medi-Cal Fee-for-Service (FFS) outpatient provider rates for Clinical Laboratory Services to no more than 80 percent of the lowest maximum allowance established by the federal Medicare program for the same or similar service
Approval Date: December 16, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

New York
Removes service limitations for physical therapy, occupational therapy, and speech-language therapy services in order to provide increased access to nonpharmacoligic treatment alternatives for pain management.
Approval Date: December 16, 2020
Effective Date: October 1, 2020
Links:
    No links available
Topics: Program Administration