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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 3911 - 3920 of 15693

Tennessee
Provides assurance of transp01tation requirements in accordance with Section 209 of the Consolidated Appropriations Act of 2021.
Approval Date: February 3, 2022
Effective Date: December 27, 2021
Topics: Program Administration

Oklahoma
Revises the language describing the methodology used to calculate the capitation rate payment for PACE organizations. The SPA will remove the Medicare Economic Index ( MEI) adjustment from the rate methodology, as the PACE capitation rate is based on the amount that would otherwise be paid (AWOP) which is reviewed annually and adjusted as needed, without regard to the MEI.
Approval Date: February 2, 2022
Effective Date: November 3, 2021
Topics: Benefits Program Administration

Washington
The purpose of this SPA is regarding Medicare cost reports. This SPA clarifies that HCA requirements to audit the cost report data used for rate setting. The SPA also clarifies that any HCA division with audit authority will audit hospital billings, as well as other financial and statistical records, and rebase the Medicaid payment system on a periodic basis. 
Approval Date: February 2, 2022
Effective Date: October 1, 2021
Topics: Financing & Reimbursement

Ohio
The proposed amendment to Attachments 4.19-A and 4.19-B of your Medicaid State plan submitted under transmittal number 21-0032 titled "Value-Based Purchasing: Suspending Episode-Based Payments Program for Calendar Year 2022.
Approval Date: February 2, 2022
Effective Date: January 1, 2022
Topics: Financing & Reimbursement

Nebraska
This amendment updates Inpatient Provider Rates for SFY 2022.  
Approval Date: February 2, 2022
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

Oregon
This amendment continues the increase to nursing facility ventilator rates at 235% of the base after the end of the public health emergency. 
Approval Date: February 2, 2022
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

Minnesota
This plan amendment makes changes to payments methods for Durable Medical Equipment (DME) to align with requirements under state law.
Approval Date: February 2, 2022
Effective Date: October 15, 2021
Topics: Financing & Reimbursement

Connecticut
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to add a temporary 5% nursing home rate eff 4/1/21 through 6/30/21. It also makes additional rate add-ons for pediatric inpatient psych services effective from June 1, 2021 through June 30, 2022, rate add-on for hospitals that increase pediatric inpatient psychiatric bed days by at least 10% or 2 beds compared with the same quarter in 2019, whichever is greater and effective July 1, 2021 through June 30, 2022 a rate add-on for pediatric inpatient psychiatric bed days provided to each child whose behavior demonstrates acuity that requires additional support on the inpatient unit and is sufficiently acute that it interferes with therapeutic participation.
Approval Date: February 2, 2022
Effective Date: March 1, 2020
Topics: Disaster Relief Reimbursement

Connecticut
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to implement payments to outpatient hospitals for providing specimen collection for COVID-19 tests when no other service is provided to that beneficiary on the same date by that hospital at 100% of the Medicare rate on Addendum B.
Approval Date: February 2, 2022
Effective Date: March 1, 2020
Topics: Disaster Relief Reimbursement

Iowa
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to implement the provider retainer payments identified in Section E of this state plan amendment (SPA) from April 1, 2020 through April 30, 2020.
Approval Date: February 2, 2022
Effective Date: March 13, 2020
Topics: Disaster Relief Reimbursement