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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 4001 - 4010 of 15693

North Dakota
Identify minimum requirements for non-emergency transportation providers.
Approval Date: December 29, 2021
Effective Date: December 27, 2021

Ohio
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to increase the reimbursement rate for the administration of in-home COVID-19 vaccinations (HCPCS M0201) for homebound individuals from the Medicare geographically adjusted Ohio rate of $33.36 to $62.02 when billed with an SY modifier.
Approval Date: December 29, 2021
Effective Date: October 1, 2021
Topics: Disaster Relief Reimbursement

North Carolina
Allows health plans to require cost sharing for certain beneficiaries under managed care. This carries over a policy for the same group under the state's fee-for-service programs, and as such will not increase costs or utilization.
Approval Date: December 28, 2021
Effective Date: July 1, 2021

Massachusetts
updates cost sharing requirements.
Approval Date: December 27, 2021
Effective Date: July 1, 2021
Topics: Program Administration

Arizona
Attests to the state’s compliance with the third party liability requirements outlined in sections 1902(a)(25)(E) and 1902(a)(25)(F)(i) of the Social Security Act.
Approval Date: December 27, 2021
Effective Date: December 31, 2021
Topics: Program Administration

Connecticut
This amendment updates CT Alternative Benefit Plan (ABP) to reflect several updates to behavioral health services, including removing the requirements for registration for all routine outpatient behavioral health. This SP A also updates the ABP to reflect the resumption of authorization for intensive outpatient
services and removal of authorization for electroconvulsive therapy.
Approval Date: December 27, 2021
Effective Date: July 1, 2021

Indiana

This amendment modifed the Medicaid Rehabilitation Option (MRO) service requirements to allow other behavioral health professionals to provide MRO services, within their scope of practice and licensure, and to allow certain MRO services to be provided concurrently with other addiction treatment services.

Approval Date: December 27, 2021
Effective Date: January 1, 2022

Oregon
Renew Oregon’s 1915(i) State Plan HCBS benefit. The effective date for this renewal is January 1, 2022.
Approval Date: December 23, 2021
Effective Date: January 1, 2022

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
Topics: Program Administration

Delaware
modifies the targeting criteria, by maintaining the minimum age as fourteen (14) and
removing the maximum age of twenty-five (25).
Approval Date: December 23, 2021
Effective Date: January 1, 2022
Topics: Eligibility Program Administration