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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 4091 - 4100 of 15708

Georgia
Remove the provision which prohibits a physician from receiving supplemental payments through the Fee-for-Service Physician Upper Payment Limit (UPL) program and the enhanced primary care reimbursement rates simultaneously.
Approval Date: December 16, 2021
Effective Date: October 1, 2021
Topics: Financing & Reimbursement

Iowa
permits IHS and Tribal facilities to claim Medicaid reimbursement under the FQHC services benefit, including the IHS All Inclusive Rate, provided outside the “four wall” of the facility.
Approval Date: December 16, 2021
Effective Date: October 1, 2021

Massachusetts
Adds EPSDT preventative behavioral health services and established the methods and standards used to set payment rates.
Approval Date: December 16, 2021
Effective Date: September 1, 2021
Topics: Financing & Reimbursement

Massachusetts

This SPA updates the providers who are able to prescribe or order durable medical equipment.

Approval Date: December 15, 2021
Effective Date: August 6, 2021

Maine
Updates the requirements for Independent Practice Dental Hygienists when they are submitting for reimbursement to MaineCare for temporary fillings, by removing two outdated consent and referral forms.
Approval Date: December 15, 2021
Effective Date: July 1, 2021

North Carolina
Allows individuals over the age of 21 to access Research-Based Intensive Behavioral Health Treatment (RBI-BHT) that prevent or minimize the disabilities and behavioral challenges associated with Autism Spectrum Disorder (ASD) and promote, to the extent practicable, the adaptive functioning of a beneficiary under the Preventative Services benefit.
Approval Date: December 15, 2021
Effective Date: July 1, 2021

Virginia
implement programmatic changes and reimbursement rates for the following: multisystemic therapy, functional family therapy, crisis intervention services, crisis stabilization services, and behavioral therapy
Approval Date: December 15, 2021
Effective Date: December 1, 2021
Topics: Program Administration

California
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to add a provider type – State-Operated Mobile Crisis Team – and to add new rate methodologies for behavioral health providers serving the developmentally disabled population under the 1915state plan home and community-based services benefit during the COVID-19 Public Health Emergency (PHE) period.
Approval Date: December 15, 2021
Effective Date: May 1, 2020
Topics: Benefits Disaster Relief Reimbursement

Colorado
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to cover COVID-19 drug treatment provided through Emergency Use Authorization effective March 1, 2020, increase the rate for procedure code 36561 from Ambulatory Surgical Center (ASC) grouper3 to ASC grouper 10, effective August 26, 2021, and increase the reimbursement rate for administration of a COVID-19 vaccine effective September 1, 2021.
Approval Date: December 15, 2021
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief Prescription Drugs Reimbursement

Nevada
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to allow for a one time supplemental payment of $500 to currently employed home care staff and another $500 retention bonus for remaining as a Medicaid home care worker for an identified six month period.
Approval Date: December 15, 2021
Effective Date: November 1, 2021
Topics: Disaster Relief Reimbursement