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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 6121 - 6130 of 15777

California
Medi-Cal reimbursement of individual and group health plan coverage.
Approval Date: December 9, 2019
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Missouri
Adds a procedure code to cover certain emergency services when a participant is treated on-site rather than being transported to an emergency department.
Approval Date: December 9, 2019
Effective Date: January 1, 2020

Oregon
revise the not to exceed limits to align with services for consumers receiving through DHS or ODDS.
Approval Date: December 6, 2019
Effective Date: January 1, 2020
Topics: Program Administration

Minnesota
Updates to various managed care sections of the State Plan.
Approval Date: December 6, 2019
Effective Date: July 1, 2019

New Jersey
Increases nursing facility Medicaid per diem rates by $13.2 million over state fiscal year 2019 rates and includes a performance rate add-on for nursing facilities scoring at or above certain metrics
Approval Date: December 5, 2019
Effective Date: July 1, 2019
Topics: Financing & Reimbursement Program Administration

Georgia
Revises the DSH language in the plan
Approval Date: December 5, 2019
Effective Date: July 1, 2019

New Jersey
Continues New Jersey's Graduate Medical Education Supplemental program for state fiscal year 2020 '
Approval Date: December 4, 2019
Effective Date: July 1, 2019

Oklahoma
Increases the nursing facility pool amounts, base rate components for nursing facilities serving adults and Aids patients. Additionally, the SPA revises the Pay-for-Performance (PFP) program, formerly known as the Focus on Excellence (FOE) program.
Approval Date: December 4, 2019
Effective Date: October 1, 2019
Topics: Financing & Reimbursement

Maryland
Update Maryland State Plan to remove the transmission fee for telehealth services to align reimbursement delivered via telehealth to in-person reimbursement
Approval Date: December 4, 2019
Effective Date: October 7, 2019
Topics: Financing & Reimbursement

Kansas
This amendment updates the base group payment rate for large public Kansas teaching hospitals so that total payments will approximate the upper payment limit.
Approval Date: December 4, 2019
Effective Date: May 17, 2019
Topics: Financing & Reimbursement