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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 5881 - 5890 of 15764

Missouri
Proposes to 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 (P.L. 115-271)
Approval Date: February 26, 2020
Effective Date: October 1, 2019
Topics: Current State Plan Prescription Drugs

South Carolina
UPL payment methodology
Approval Date: February 25, 2020
Effective Date: October 1, 2019
Topics: Financing & Reimbursement

Arizona
updates the State Plan other provider rates
Approval Date: February 25, 2020
Effective Date: October 1, 2019

California
Supplemental payments for Hospital Inpatient Services
Approval Date: February 25, 2020
Effective Date: July 1, 2019
Topics: Financing & Reimbursement

California
Supplemental payments for Hospital Outpatient Services
Approval Date: February 25, 2020
Effective Date: July 1, 2019
Topics: Financing & Reimbursement

California
Supplemental payments for Hospital Inpatient Services
Approval Date: February 25, 2020
Effective Date: July 1, 2019
Topics: Financing & Reimbursement

Pennsylvania
This SPA authorizes the DHS to continue to make county nursing facility safety net payments to qualifying county nursing facilities in Fiscal Year (FY) 2019-2020. The DHS published a public notice in the Pennsylvania Bulletin on January 11, 2020.  To qualify for a safety net payment, the facility must be a county nursing facility both during the period for which the payment is being made and at the time the payment is made. County nursing facilities located in a geographic zone where the Community HealthChoices (CHC) program will be in operation for the entire 2019-2020 fiscal year are not eligible for this payment.
Approval Date: February 25, 2020
Effective Date: January 13, 2020
Topics: Financing & Reimbursement Program Administration

Pennsylvania
This SPA continues funding of DSH payments to qualifying MA-enrolled acute care general hospitals that provide a high volume of inpatient services to MA eligible and low income populations. These payments are intended to promote access to medically necessary inpatient services for MA eligible persons. The DHS published notice of its intent to allocate funding for these payments in the Pennsylvania Bulletin on December 21, 2019, at 49 Pa.B. 7541. 
Approval Date: February 25, 2020
Effective Date: December 22, 2019
Topics: Financing & Reimbursement

Louisiana
Requests to amend the provisions governing the public process for managed care organizations (MCOs) by removing language that refers to the utilization of rulemaking to satisfy public comment requirements. The amendment also adds language to require a 30-day public comment period for MCO contract amendments and a 45-day public comment period for policy or procedure changes (unless the Louisiana Department of Health finds that imminent peril to the public's health, safety, or welfare requires immediate approval).
Approval Date: February 24, 2020
Effective Date: January 1, 2020

South Carolina
Updates SC DSH program as well as inpatient hospital payments
Approval Date: February 24, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement