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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 1171 - 1180 of 15690

Colorado

This plan amendment updates the pricing methodology for hospital services using certain specialty drugs delivered in the outpatient hospital setting.

Approval Date: March 27, 2024
Effective Date: January 1, 2024

Massachusetts

An amendment to update rate year 2024 payment methodologies for nursing facilities services.

Approval Date: March 27, 2024
Effective Date: October 1, 2023

Louisiana

Amend the provisions governing inpatient hospital services to clarify the purpose of the affiliated agreement that hospitals must have with an accredited institution for major or minor teaching hospital graduation education training and the options applicable for residency programs.

Approval Date: March 27, 2024
Effective Date: February 20, 2024

Idaho

Amendment to the State Plan to update the Private, State, and County-Owned Nursing Facility Supplemental Payment section to reflect changes requested by CMS before implementing the Department’s new Patient Driven Payment Methodology Upper Payment Limit (PDPM UPL) methodology.

Approval Date: March 27, 2024
Effective Date: October 1, 2023

Nevada

The proposed amendment will increase reimbursement rates for Nursing Facilities.

Approval Date: March 26, 2024
Effective Date: January 1, 2024

Colorado

Updates the pricing methodology for hospital services utilizing certain specialty drugs delivered in the inpatient hospital setting, paying a percentage of net invoice cost or full invoice cost, depending on the drug.

Approval Date: March 26, 2024
Effective Date: January 1, 2024

Illinois

This SPA increases the monthly personal needs allowance for Medicaid beneficiaries residing in nursing facilities.

Approval Date: March 26, 2024
Effective Date: January 1, 2024

Utah

This amendment modifies the postpartum period referenced in coverage pages from 60 days to 12 months.

Approval Date: March 25, 2024
Effective Date: January 1, 2024

New York

To add coverage to Medicaid for preventive health services provided by doulas to pregnant and postpartum individuals.

Approval Date: March 25, 2024
Effective Date: January 1, 2024

New York

To authorize payment for Evidence-Based Practices (EBPs) provided to children/youth referred and eligible for Children and Family Treatment and Support Services (CFTSS) by agencies designated in Other Licensed Practitioner (OLP) and/or Community Psychiatric Supports and Treatment (CPST) by the New York State designation process that have completed the EBP training and certification process.

Approval Date: March 25, 2024
Effective Date: November 1, 2024
Topics: Other Licensed Practitioners