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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 4311 - 4320 of 15708

New York
continues UPL supplemental payments to private hospitals for inpatient services in the amount of $275,082,185 for state fiscal year 2022.
Approval Date: September 23, 2021
Effective Date: April 1, 2021
Topics: Financing & Reimbursement

New York
Continues supplemental payments from a pool amount of $8,561,531 for all inpatient services provided by State government-owned hospitals.
Approval Date: September 23, 2021
Effective Date: April 1, 2021
Topics: Program Administration

South Dakota
This plan amendment implements community mental health center and substance use disorder agency inflationary rate increases appropriated by the state legislature during the 2021 legislative session
Approval Date: September 23, 2021
Effective Date: June 1, 2021
Topics: Financing & Reimbursement

South Carolina
The purpose of this SPA is to update the Program of All-Inclusive Care for the Elderly (PACE) rate methodology in the South Carolina State Plan.
Approval Date: September 23, 2021
Effective Date: July 1, 2021
Topics: Coverage Financing & Reimbursement

Colorado
This amendment extends the adult dental benefit maximum of $1,500
Approval Date: September 23, 2021
Effective Date: April 1, 2021

Ohio
Adds coverage and payment provisions to the Ohio Medicaid state plan for lactation counseling services provided by dieticians. Coverage and payment for lactation counseling provided by dieticians is being added to assist with improving the health of the population and reducing future preventable causes of poor health, such as obesity, in infants. CMS supports this action because it will improve infant health overall
Approval Date: September 23, 2021
Effective Date: July 1, 2021
Topics: Coverage Financing & Reimbursement

Mississippi
This SPA proposes to allow the Division of Medicaid (DOM) to 1) revise coverage and payment methodology for extended services for pregnant and post-partum women who are at risk of morbidity or mortality, 2) set the fees for extended services for pregnant women the same as those in effect on July 1, 2021, and 3) remove the five percent (5%) reimbursement reduction effective July 1, 2021.
Approval Date: September 23, 2021
Effective Date: July 1, 2021
Topics: Coverage Financing & Reimbursement

Mississippi
This SPA modifies
Attachment 4.19-D of Mississippi’s Title XIX State Plan. Specifically, the amendment proposes to freeze all long-term care facility rates in effect July 1, 2021
Approval Date: September 23, 2021
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

Mississippi

This amendment proposes to update the following hospital inpatient services effective July 1, 2021: 1) Update APR-DRG parameters, 2) use cost-to-charge (CCRs) ratios in effect July 1, 2021 to calculate outlier payments for claims with last dates of service on or after July 1, 2021, and 3) remove language that intensive outpatient programs and partial hospitalization programs are not covered in the outpatient hospital setting.

Approval Date: September 23, 2021
Effective Date: July 1, 2021
Topics: Inpatient Reimbursement

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 a payment rate increase for personal care assistance services.
Approval Date: September 22, 2021
Effective Date: October 1, 2021
Topics: Disaster Relief Reimbursement