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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 4181 - 4190 of 15875

Colorado
adds clarifying language specific in how Graduate Medical Education (GME) payments are made to hospitals for inpatient and outpatient hospital services provided to Medicaid managed care clients.
Approval Date: December 23, 2021
Effective Date: October 1, 2021

South Dakota
Provides assurances that the State is in compliance with federal regulation regarding third party liability.
Approval Date: December 22, 2021
Effective Date: November 1, 2022

Montana
Renamed an existing EPSDT service to Comprehensive Behavioral Health Treatment, clarifies the amiability of comparable services to individuals not enrolled in public schools, and authorized an Intergovernmental Transfer (IGT) methodology for the state share of the service's reimbursement.
Approval Date: December 22, 2021
Effective Date: October 1, 2022

Virginia
Allows the pending, reviewing, and reduction of emergency department payment amounts for avoidable emergency room claims for state plan authorized fee-for-service benefits coded as 99282, 99283 and 99284.
Approval Date: December 22, 2021
Effective Date: July 1, 2020

North Dakota
This amendment expands the number of acceptable ICD_10 Diagnoses for individual with the diagnosis of brain injury, behavioral health condition and/or substance abuse disorder.
Approval Date: December 22, 2021
Effective Date: January 1, 2022

Connecticut
CT-21-0033 which proposed to amend Connecticut's Medically Needy Income Levels and the income standards for Connecticut's optional state supplement program.
Approval Date: December 22, 2021
Effective Date: July 1, 2021

Texas
This SPA proposes to revise the methodology for assessing payment adjustments for Potentially Preventable Readmissions.
Approval Date: December 22, 2021
Effective Date: September 1, 2021

Montana
Updates the reimbursement methodology for psychiatric residential treatment facility services for State Fiscal Year 2022.
Approval Date: December 22, 2021
Effective Date: July 1, 2021

Nebraska
Intermediate Care Facility for Individuals with Developmental Disabilities (ICF-DD) Rates
Approval Date: December 22, 2021
Effective Date: July 1, 2021

Arizona
Updates the nursing facility Differential Adjusted Payment (DAP) program 
Approval Date: December 22, 2021
Effective Date: October 1, 2021