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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 861 - 870 of 15696

Nebraska

This amendment is to make changes to the Nebraska State Plan regarding cost-sharing provisions for certain Medicaid beneficiaries enrolled in the Medicaid Insurance for Workers with Disabilities (MIWD) program.

Approval Date: July 5, 2024
Effective Date: May 1, 2024

Puerto Rico

To update the territory’s premiums and cost-sharing payment tracking process.

Approval Date: July 3, 2024
Effective Date: April 1, 2024

Montana

This amendment is to increase the monetary limit for dental services coverage and removes a specified tooth restriction for certain restorative porcelain and ceramic substrate crowns for individuals aged 21 and older.

Approval Date: July 3, 2024
Effective Date: July 1, 2024

North Dakota

This plan amendment proposes an increase of three percent for 1915(i) Services.

Approval Date: July 1, 2024
Effective Date: July 1, 2024

Connecticut

This amendment continues certain flexibilities previously approved in Disaster Relief State Plan Amendments and a Section 1135 Disaster Relief waiver.

Approval Date: July 1, 2024
Effective Date: May 12, 2023
Topics: Coverage Disaster Relief Other Licensed Practitioners Reimbursement

Rhode Island

This amendment proposes a revision to the State Plan language for Provider qualifications regarding Enhanced MHPRR (E-MHPRR) services.

Approval Date: July 1, 2024
Effective Date: April 1, 2024
Topics: Coverage Managed Care Other Licensed Practitioners Program Administration

Vermont

This amendment is to suspend temporarily pharmacy co-payments for dates of service starting February 21, 2024, through March 18, 2024, in response to the Change Healthcare cybersecurity incident in alignment with the CMCS Informational Bulletin.

Approval Date: June 28, 2024
Effective Date: February 21, 2024
Topics: Cost Sharing Prescription Drugs

New York

This plan amendment implements a 5% rate increase for licensed Continuing Day Treatment, Day Treatment for Children, and Partial Hospitalization services.

Approval Date: June 28, 2024
Effective Date: July 1, 2022

New York

This plan amendment implements a 1% increase to the operating component of most Medicaid rates under the State’s non-institutional state plan section 4.19-B.

Approval Date: June 28, 2024
Effective Date: April 1, 2022

New York

This plan amendment implements a 5.4% Cost of Living Adjustment (COLA) for outpatient hospital services, including Outpatient Rehabilitation, and Opioid Treatment Programs.

Approval Date: June 28, 2024
Effective Date: April 1, 2022