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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 3971 - 3980 of 15693

Pennsylvania
alternative payment methodology to increase funding for FQHCs located in/operated by cities of the first class.
Approval Date: January 18, 2022
Effective Date: October 31, 2021
Topics: Financing & Reimbursement

Maine
Updates the total hospital supplemental payment pool amount on the outpatient hospital pages.
Approval Date: January 18, 2022
Effective Date: October 1, 2021

New Mexico
Targeted Access Payments
Approval Date: January 16, 2022
Effective Date: December 15, 2021
Topics: Financing & Reimbursement

Michigan
Provides authority to make technical changes regarding Third Party Liability and coordination of benefits processing.
Approval Date: January 14, 2022
Effective Date: January 1, 2022
Topics: Program Administration

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 rescind the flexibilities in which the state authorized a 90-day supply of medication other than controlled substance medications and allowed prescription refills when 80% or more of the prescription was used.
Approval Date: January 14, 2022
Effective Date: April 19, 2021
Topics: Disaster Relief Prescription Drugs

Maine
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to make Hospital APC payments for vaccine administration equals 100% of Maine Medicare rate; add/adjust reimbursement for medication management by Behavioral Health providers; implement a one-time supplemental payment of $23 million (inpatient $12.5 million/outpatient $10.5 million); implement a supplemental payment of $2,079,376 to Adult Family Care Services providers, add crisis services under behavioral health professional; and allow several providers to provide crisis services.
Approval Date: January 14, 2022
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief Reimbursement

Michigan
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 allow for a temporary change to the nursing facility rate setting methodology.
Approval Date: January 14, 2022
Effective Date: October 1, 2021
Topics: Disaster Relief Reimbursement

Utah
Provides assurances that the State is in compliance with federal regulations regarding third party liability.
Approval Date: January 14, 2022
Effective Date: October 1, 2022

Minnesota
Provides requirements for Non-Emergency Medical Transportation (NEMT).
Approval Date: January 13, 2022
Effective Date: December 27, 2021
Topics: Program Administration

New Hampshire
NEMT Assurance
Approval Date: January 13, 2022
Effective Date: October 1, 2021
Topics: Program Administration