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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 4351 - 4360 of 15708

Virginia
Increases the rates for psychiatric services, anesthesiologists, and supplemental physician payments 
Approval Date: September 15, 2021
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

California
Adds Medication Therapy Management (MTM) to Licensed Pharmacist Services under the Other Licensed Practitioner (OLP) benefit; remove the Treatment Authorization Request (TAR) requirement from Licensed Pharmacist Services; and updates the rate methodology for Licensed Pharmacist Services by adding rates for MTM
Approval Date: September 15, 2021
Effective Date: July 1, 2021

Illinois
Proposes to increase encounter rates for FQHCs
Approval Date: September 15, 2021
Effective Date: April 1, 2021
Topics: Financing & Reimbursement

California
updates to the Skilled Nursing Facility Quality and Accountability Supplement Payment (QASP) for the rate periods from August 1, 2020 to December 31, 2021
Approval Date: September 13, 2021
Effective Date: August 1, 2021
Topics: Program Administration

Georgia
increases the rates for specialized nursing home mechanical ventilator care.
Approval Date: September 13, 2021
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

Massachusetts
Updates the definition of undue hardship for estate recovery; updates the state's determination of cost effectiveness for estate recovery; clarify the process for exempting certain assets from estate recovery for American Indians and Alaska Natives; and updates the limitations to estate recovery for any premiums paid on behalf of the member.
Approval Date: September 13, 2021
Effective Date: May 14, 2021
Topics: Program Administration

Mississippi
set the fees for transportation services the same as those in effect on July1, 2020, and removes the five percent (5%) reimbursement reduction effective July 1, 2021. This SPA also revises the coverage page to include attestation to meeting the federal transportation minimum requirements.
Approval Date: September 13, 2021
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

North Carolina
Adds a tribal Primary Care Case Management Program to the State Plan
Approval Date: September 13, 2021
Effective Date: July 1, 2021
Topics: Indian Health Services

Michigan
Provides authority to allow Tribal 638 pharmacies to be reimbursed at the Indian Health Services outpatient all-inclusive rate (A.I.R.) per visit
Approval Date: September 13, 2021
Effective Date: October 1, 2021
Topics: Financing & Reimbursement Indian Health Services

Mississippi
This amendment updates coverage and reimbursement of targeted case management (TCM) for infants under the age of one to comply with federal regulations 42 C.F.R. §§ 440. 169 and 441.18.
Approval Date: September 13, 2021
Effective Date: July 1, 2021
Topics: Financing & Reimbursement