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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 4611 - 4620 of 15708

North Carolina
Effective January 1, 2021, this amendment increases Personal Care Services Medicaid rates by ten percent (10%) above the rate in effect. This increase is mandated by Section 12006 1903(l) of the 21st Century CURES Act.
Approval Date: June 14, 2021
Effective Date: January 1, 2021
Topics: 21st Century Cures Act Financing & Reimbursement

Alabama
Effective April 1, 2021, this amendment adds the optional eligibility group described at section 1902(a)(19)(A)(ii)(XXII) of the Social Security Act to the Alabama state Medicaid plan (the "Individuals Receiving State Plan Home and Community-Based Services group," or "219(a) group").
Approval Date: June 14, 2021
Effective Date: April 1, 2021

Massachusetts
Effective January 1, 2021, this plan amendment updates the methods and standards used by Massachusetts to set payment rates for Home Health services.
Approval Date: June 14, 2021
Effective Date: January 1, 2021
Topics: Financing & Reimbursement

Massachusetts
Effective January 22, 2021, this amendment revises reimbursement for inpatient hospital psychiatric services. Specifically, it implements adult and pediatric supplemental per diem payments for the rate year 2021 performance period.
Approval Date: June 14, 2021
Effective Date: January 22, 2021
Topics: Financing & Reimbursement

Washington
Effective January 1, 2021, this amendment adopts a new resource disregard under the authority of section 1902(r)(2) of the Social Security Act. The agency chooses to provide a reasonable timeframe for reducing excess resources accumulated during the COVID-19 public health emergency (PHE) by certain individuals subject to the post-eligibility treatment of income (PETI) rules for long-term services and supports (LTSS). Under FFCRA, these individuals accumulated extra resources, due to no changes being made to their PETI. Income they would have otherwise paid toward the cost of their care resulted in an increase in their resources that began to exceed program standards. This methodology also will prevent an institutionalized beneficiary from having to spend down any such excess resources during the PHE.  This methodology will remain in effect through the twelve months following the end of the COVID-19 PHE.
Approval Date: June 14, 2021
Effective Date: January 1, 2021
Topics: Allocation Methodologies Eligibility Financing & Reimbursement

Nebraska
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment for nursing facilities to receive an additional $20 per day payment per Medicaid beneficiary effective from the dates of January 1, 2021 to June 30, 2021.
Approval Date: June 11, 2021
Effective Date: January 1, 2021
Topics: Disaster Relief Financing & Reimbursement

Alaska
Effective effective October 1, 2020 until September 30, 2025, this amendment implements the time-limited mandatory medication assisted treatment benefit (MAT) per section 1006(b) of the SUPPORT Act to address opioid addiction. Section 1006(b) of the SUPPORT for Patients and Communities Act (SUPPORT Act), signed into law on October 24, 2018, amended section 1902(a)(10)(A) of the Act to require state Medicaid plans to include coverage of MAT for all eligible to enroll in the state plan or waiver of state plan. Section 1006(b) also added a new paragraph 1905(a)(29) to the Act to include the new required benefit in the definition of “medical assistance” and to specify that the new required benefit will be in effect for the period beginning October 1, 2020, and ending September 30, 2025.
Approval Date: June 11, 2021
Effective Date: October 1, 2020
Topics: Benefits Program Administration

Nebraska
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to allow pharmacists to order and administer certain Covid-19 vaccines, including Pfizer and Moderna vaccines currently available, where a pharmacist has met CMS training requirements and state regulations for training and vaccine administration.
Approval Date: June 11, 2021
Effective Date: December 1, 2020
Topics: Disaster Relief Vaccine

Vermont
This SPA proposes to allow physician assistants to enroll directly with Vermont Medicaid as primary care providers.
Approval Date: June 11, 2021
Effective Date: January 1, 2021

Connecticut
Incorporates the 2021 Healthcare Common Procedural Coding System (HCPCS) changes (additions, deletions and description changes) to the Independent Radiology and Independent laboratory fee schedules 
Approval Date: June 10, 2021
Effective Date: January 1, 2021