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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 4201 - 4210 of 15690

Pennsylvania
The SPA authorizes an additional class of disproportionate share hospital payments to facilities treating a high number of COVID-19 patients. 
Approval Date: November 8, 2021
Effective Date: September 12, 2021
Topics: Financing & Reimbursement

New Mexico
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to add vaccine administration for homebound beneficiaries under the preventive services benefit, including a brief health screening, in addition to administration of the COVID vaccine, and to add a reimbursement methodology to those services.
Approval Date: November 5, 2021
Effective Date: March 15, 2021
Topics: Benefits Disaster Relief Reimbursement

Texas
Updates the physicians' and other practitioners' fee schedules.
Approval Date: November 5, 2021
Effective Date: September 1, 2021
Topics: Program Administration

Colorado

Updates the outpatient pharmacy rate methodology for blood clotting factor drugs by incorporating Average Acquisition Cost (AAC) and Clotting Factor Maximum Allowable Cost (CFMAC) rates, along with a $0.03/unit enhanced professional dispensing fee.

Approval Date: November 5, 2021
Effective Date: April 1, 2022
Topics: Financing & Reimbursement Program Administration

Nevada
Continues the authority for the Indigent Accident Fund program, a supplemental payment program based on inpatient hospital utilization to preserve access to inpatient hospital services, through state fiscal year 2022.
Approval Date: November 5, 2021
Effective Date: July 1, 2021
Topics: Program Administration

Michigan
This SPA provides reimbursement methodology for rapid whole genome sequencing testing provided in the inpatient hospital setting.
Approval Date: November 5, 2021
Effective Date: September 1, 2021
Topics: Financing & Reimbursement

Arizona
Administers changes to transportation services to permit emergency transportation to alternative facilities.
Approval Date: November 4, 2021
Effective Date: October 1, 2021
Topics: Program Administration

Delaware
Adds medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan.
Approval Date: November 3, 2021
Effective Date: October 1, 2021

Louisiana
Implements extension of the exception from participation in the Recovery Audit Contractor (RAC) Program.
Approval Date: November 2, 2021
Effective Date: August 6, 2021

Michigan
Expands the OHH in select Michigan counties.
Approval Date: November 2, 2021
Effective Date: October 1, 2021