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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 4011 - 4020 of 15693

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
Topics: Benefits Delivery System

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
Topics: Program Administration

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
Topics: Financing & Reimbursement

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

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

Texas
This proposed amendment will adjust the payment rate methodology for pediatric nursing
facilities so that it is based upon the unadjusted federal per diem rate for rural Medicare skilled
nursing facilities for the most recent federal fiscal year.
Approval Date: December 22, 2021
Effective Date: September 1, 2021
Topics: Financing & Reimbursement

Montana
This plan amendment allows for the reimbursement of providers according to the new rates, as posted on the state’s fee schedules, that have been calculated using the appropriations from the 2021 Montana legislative session
Approval Date: December 22, 2021
Effective Date: July 1, 2022
Topics: Financing & Reimbursement

Montana
The EPSDT Medicaid State Plan will be amended to update the of the fee schedule to implement a revised fee schedule, which reflects updated reimbursements rates for all services
Approval Date: December 22, 2021
Effective Date: July 1, 2021
Links:
    No links available
Topics: Coverage

California
Revises the reimbursement rate methodology for Intermediate Care Facilities for the Developmentally Disabled (ICF/DD), ICF/DD-Habilitative (ICF/DD-H), and ICF/DD-Nursing (ICF/DD-N).
Approval Date: December 22, 2021
Effective Date: August 1, 2021
Topics: Financing & Reimbursement