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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 5061 - 5070 of 15745

Colorado
provides for a one percent decrease for inpatient hospital services
Approval Date: December 21, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement Program Administration

Colorado
Updates the payment amount for the University of Colorado School of Medicine Supplemental Payment for Physician and Professional Services at qualifying Colorado State-Owned or Operated Professional Services Practices. 
Approval Date: December 21, 2020
Effective Date: July 1, 2020
Topics: Program Administration

Colorado
Effective for services on or after July 1, 2020, this amendment implements a 1 % across-the-board rate decrease for non-institutional services and psychiatric residential treatment facilities (PRTFs) as appropriated by the legislature during the 2020 legislative session. 
Approval Date: December 21, 2020
Effective Date: July 1, 2020
Topics: Program Administration

Colorado
Provides that pediatric specialty hospitals will receive a one percent reduction to each hospital’s July 1, 2019 Medicaid base rate. In addition, it updates the budget neutrality factor for state fiscal year (SFY) 2021.
Approval Date: December 21, 2020
Effective Date: July 1, 2020
Topics: Program Administration

Minnesota
Mental health crisis and withdrawal management services.
Approval Date: December 18, 2020
Effective Date: August 1, 2020
Topics: Program Administration

Nebraska
Increases rates for outpatient and professional services
Approval Date: December 18, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

California
Allow permanent waiver of the annual recertification of level of care requirement in accordance with
441.510(c)(1) & (2) and allow a temporary waiver for other specific situations
Approval Date: December 17, 2020
Effective Date: July 1, 2020
Topics: Program Administration

Colorado
Adds residential and inpatient SUD treatment and withdrawal management services as covered services
Approval Date: December 17, 2020
Effective Date: January 1, 2021

Alabama
Proposes to amend the value/outcomes based agreement template in order to further facilitate obtaining supplemental rebates
Approval Date: December 17, 2020
Effective Date: December 1, 2020

North Carolina
This SPA proposes to add the provider’s gross amount due (GAD) to the reimbursement hierarchy for covered outpatient drugs.  This SPA also proposes to implement a new reimbursement methodology for Indian Health Services/Indian Tribal pharmacy facilities based on the OMB encounter rate, as well as adding a delivery payment for drugs delivery by mail, courier, or person-to-person.
Approval Date: December 17, 2020
Effective Date: September 1, 2020
Topics: Financing & Reimbursement