U.S. flag

An official website of the United States government

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 5671 - 5680 of 15756

California
Clarifies which Non-Emergency Medical Transportation (NEMT) procedure codes are eligible to receive a time-limited supplemental payment (through December 31, 2021)
Approval Date: April 30, 2020
Effective Date: January 1, 2020
Topics: Eligibility Program Administration

Hawaii
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to lift the day limit for reserved bed days with the prior approval of the Medicaid agency's medical consultant.
Approval Date: April 30, 2020
Effective Date: March 1, 2020
Topics: Disaster Relief Financing & Reimbursement

Kentucky
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow long-term care facilities to receive an increased reimbursement for COVID19 patients, extend the hold days from 14-30 days and to allow hospitals to be paid for administrative days during the COVID19 state of emergency.
Approval Date: April 29, 2020
Effective Date: April 1, 2020
Topics: Disaster Relief Financing & Reimbursement

Arkansas
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to suspend cost-sharing for all eligibility groups for COVID-19 testing and treatment, add new optional benefits (management and evaluation service for adults with SMI; well-check service for children and adults with developmental disabilities); adjust benefits currently in the state plan (exempt certain services from annual limits when associated with testing or treatment of COVID-19); allow 90-day supplies of drugs and early refills; allow exceptions to the State's preferred drug list in case of shortages; establish payments for the new optional benefits; increase rates for direct care services and day habilitation; establish payments for delivering existing services through telehealth; and establish rates for COVID-19 screening and testing.
Approval Date: April 29, 2020
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief Eligibility Financing & Reimbursement Prescription Drugs

Arizona
Proposes to authorize the state to enter outcome-based supplemental rebate agreements with drug manufacturers for drugs provided to the Medicaid program
Approval Date: April 28, 2020
Effective Date: July 1, 2019
Topics: Financing & Reimbursement Prescription Drugs

California

Updates the payment methodology for the Local Educational Agency (LEA) Medi-Cal Billing Option Program

Approval Date: April 28, 2020
Effective Date: July 1, 2015
Topics: Financing & Reimbursement

Louisiana
Amend the provisions governing reimbursement in the Pharmacy Benefits Management Program in order to add vaccines for adult recipients as a pharmacy benefit to provide an alternative location for these recipients to receive necessary vaccinations and immunizations.
Approval Date: April 24, 2020
Effective Date: March 20, 2020
Topics: Financing & Reimbursement

Pennsylvania
Continues an additional class of disproportionate share hospital payment to qualifying hospitals
that provide medical and surgical services for ocular disease and injuries
Approval Date: April 24, 2020
Effective Date: March 8, 2020
Topics: Financing & Reimbursement Program Administration

Oregon
This SPA adds Lactation Consultant Services as a billable provider type
Approval Date: April 24, 2020
Effective Date: April 1, 2020

Michigan
Proposes to reimburse for psychiatric diagnostic evaluations services for beneficiaries under 21 years of age at 100% of the annual Medicare rates published each year.
Approval Date: April 24, 2020
Effective Date: February 1, 2020
Topics: Financing & Reimbursement