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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 5431 - 5440 of 15756

Ohio
Change the beginning date of coverage for individuals given a Reasonable Opportunity Period (ROP) from the date of the application to the to the first day of the month in which the application is received. 
Approval Date: July 29, 2020
Effective Date: April 1, 2020

Rhode Island
“Exemption from the Recovery Audit Contractor Program,” which transmitted language to the NH Title XIX to extend the current exemption to the Recovery Audit Contractors (RACs) requirement to have a vendor that identifies and corrects improper Medicaid payments through the collection of over payments and reimbursement of underpayments from July 1, 2020 to June 30, 2022.
Approval Date: July 29, 2020
Effective Date: July 1, 2020
Topics: Program Administration

Wisconsin
Electronic Visit Verification system
Approval Date: July 29, 2020
Effective Date: April 30, 2020
Topics: Program Administration

New Hampshire
Other Licensed Practitioners – Pharmacists Services
Approval Date: July 29, 2020
Effective Date: April 8, 2020
Topics: Program Administration

Oklahoma
revise coverage and reimbursement methodology for Durable Medical Equipment (DME), supplies and appliances. 
Approval Date: July 29, 2020
Effective Date: August 1, 2020
Topics: Financing & Reimbursement

Arizona
CMS is approving this state plan amendment to respond to the COVID-19 national emergency. The purpose of this SPA is to rescind the optional eligibility group in Section A.1 that was previously approved in an earlier COVID-19 emergency state plan amendment.
Approval Date: July 28, 2020
Effective Date: April 1, 2020
Topics: Disaster Relief Eligibility

Iowa
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 a temporary enhanced payment to dental providers to help address facility and safety upgrades. The Department will reprocess special payment of claims received with dates of service between May 1 and August 31, 2020.
Approval Date: July 24, 2020
Effective Date: May 1, 2020
Topics: Disaster Relief Financing & Reimbursement

New Jersey
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to expand entities qualified to make presumptive eligibility determinations, all for adjustments to benefits currently covered in the state plan (e.g. Personal Care Assistant Services; Care Management Organization Targeted Case Management Staffing), expand telehealth, adjust prior authorizations for medications, decrease certain payments (quarterly rather than monthly basis), expand bed hold limits due to COVID, and alteration of Behavioral Health Home travel protocols.
Approval Date: July 23, 2020
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief Eligibility Financing & Reimbursement Prescription Drugs

Hawaii
This plan amendment implements the requirements of Section 1903(i)(27) of the Social Security Act concerning reimbursement for durable medical equipment.
Approval Date: July 23, 2020
Effective Date: October 1, 2019
Topics: Financing & Reimbursement

Oregon
Revises the alternative paper application to align with the state’s online eligibility system
Approval Date: July 22, 2020
Effective Date: October 31, 2019