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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 4521 - 4530 of 15763

Ohio
Institutes for Mental Disease – Disproportionate Share Hospital (IMD-DSH)
Approval Date: August 9, 2021
Effective Date: April 1, 2021

Wyoming
Requests an exception of the State’s requirement to contract with a Medicaid Recovery Audit Contractor
Approval Date: August 6, 2021
Effective Date: July 1, 2021

Oklahoma
This SPA was submitted to annotate that the state requires providers to bill liable third parties when services covered under the Plan are furnished to a member on whose behalf child support enforcement is being carried out
Approval Date: August 6, 2021
Effective Date: July 1, 2021
Links:
    No links available
Topics: Program Administration

South Dakota

This plan amendment updates the quality incentive payment methodology for providers by improving the Health Home composite measures and aligning the clinical outcome payment methodology to it.

Approval Date: August 5, 2021
Effective Date: May 1, 2021

Kansas
This amendment proposes to add medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan
Approval Date: August 5, 2021
Effective Date: October 1, 2020

Minnesota
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to rescind, effective February 9, 2021, the election at a temporary rate increase for personal care assistance service.
Approval Date: August 4, 2021
Effective Date: February 8, 2021
Topics: Disaster Relief Reimbursement

Connecticut
Effective April 1, 2021, this amendment updates the physician office and outpatient fee schedule to incorporate various Healthcare Common Procedure Coding System (HCPCS) updates (additions, deletions and description changes) from the most recent HCPCS quarterly update issued by CMS. Codes that are being added are being priced using a comparable methodology to other codes in the same or similar category. 
Approval Date: August 4, 2021
Effective Date: April 1, 2021
Topics: Financing & Reimbursement

Pennsylvania
Authorizes a new class of supplemental payments to facilities that treat a high volume of opioid use disorder patients in emergency rooms
Approval Date: August 4, 2021
Effective Date: May 23, 2021
Topics: Financing & Reimbursement

Missouri
Effective July 20, 2021, this amendment revises the reimbursement methodology for outpatient services.
Approval Date: August 3, 2021
Effective Date: July 20, 2021
Topics: Financing & Reimbursement

Connecticut
Effective April 1, 2021, this amendment updates the DME fee schedule to incorporate the April 2021 Healthcare Common Procedure Coding System (HCPCS) changes to remain compliant with the Health Insurance Portability and Accountability Act (HIPPA). Newly added codes are priced using a comparable methodology to other codes in the same or similar category.
Approval Date: August 3, 2021
Effective Date: April 1, 2021
Topics: Financing & Reimbursement