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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 5851 - 5860 of 15760

North Dakota
Amends the North Dakota State Plan regarding the payment methodology for Tribal 638 facilities that elect to enroll as a Federally Qualified Health Center. 
Approval Date: March 4, 2020
Effective Date: January 1, 2019
Topics: Financing & Reimbursement Program Administration

New York
This State Plan Amendment proposes to revise the rate setting methodology for NYS Office of Alcoholism and Substance Abuse Services (OASAS) freestanding Medically Supervised Inpatient Withdrawal (MSIW) programs. The program will move to site-specific per-diem fees, which are inclusive of capital costs, based on a regression model that uses normalized cost per bed in comparison to service volume. Fees will be assigned to each facility based on its base year service volume (as a proxy for bed size) and a regional cost factor. The fees for each bed size are detailed in the SPA. 
Approval Date: March 4, 2020
Effective Date: January 1, 2019
Topics: Financing & Reimbursement Program Administration

Nevada
The state plan amendment establishes services and a reimbursement methodology for Certified Community Behavioral Health Clinics (CCBHCs) in the state plan. 
Approval Date: March 4, 2020
Effective Date: August 1, 2019
Topics: Benefits Financing & Reimbursement

Oregon
Adds clarifying language that the Department pays the PACE capitation rate based on a consumers Medicare status
Approval Date: March 4, 2020
Effective Date: January 1, 2020
Topics: Program Administration

New York
Supplemental payment based on CY 2019 UPL for non-state public hospitals in cities with more than one million persons.
Approval Date: March 3, 2020
Effective Date: April 1, 2019
Topics: Financing & Reimbursement

Florida
This amendment includes the Private and Charter School Reimbursement Methodology for services outlined within the State Plan. 
Approval Date: March 3, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

North Carolina
allow the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act.
Approval Date: March 2, 2020
Effective Date: January 1, 2020

Nebraska
This SPA allows the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act.
Approval Date: March 2, 2020
Effective Date: October 1, 2019
Topics: Program Administration

Oregon
This SPA amends the current Targeted Case Management State Plan Amendment for Public Health Nurse Home Visiting to include 3 additional counties.
Approval Date: March 2, 2020
Effective Date: April 1, 2020
Topics: Benefits Program Administration

Maine
This eligibility SPA increases the eligibility thresholds for the state’s Medicare Savings Program eligibility groups effective 2/1/20. This SPA also updates the levels for the Optional State Supplement Beneficiaries group effective 1/1/20
Approval Date: March 2, 2020
Effective Date: December 4, 2019