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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 2061 - 2070 of 15696

Washington
This amendment will add language back to the Medicaid State Plan to clarify the state covers and reimburses all United States Preventive Services Task Force (USPSTF) grade A and B preventive services and approved vaccines recommended by the Advisory Committee on Immunization Practices (ACIP).
Approval Date: July 20, 2023
Effective Date: April 1, 2023

California

Effective July 1, 2023, this amendment modifies the reimbursement methodology for Medi-Cal behavioral health services.

Approval Date: July 20, 2023
Effective Date: July 1, 2023

Kentucky

This SPA proposes to change the state’s multi-state Supplemental Rebate Agreement arrangement from being with National Medicaid Pooling Initiative (NMPI) to joining the Sovereign States Drug Consortium (SSDC). The SPA also proposes to allow the state to enter into individual Supplemental Rebate Agreements directly with manufacturers.

Approval Date: July 20, 2023
Effective Date: January 1, 2024
Topics: Drugs Purchased Drugs and Related Services Prescription Drugs

Ohio
CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency.  The purpose of this amendment is to temporarily extend the suspension of premiums for the Medicaid Buy-In for Workers with Disabilities (MBIWD) effective 5/12/23 through 7/31/23. This provision was approved in disaster relief SPA OH-22-0013 effective 7/1/21.
Approval Date: July 19, 2023
Effective Date: May 12, 2023
Topics: Disaster Relief Eligibility

Kansas
This plan amendment will set the laboratory reimbursement rates to be between 85% and 100% of Medicare.
Approval Date: July 19, 2023
Effective Date: July 1, 2023

Wisconsin
This amendment will include vaccine counseling as a covered service under the State Plan
Approval Date: July 19, 2023
Effective Date: April 1, 2023

Louisiana
The purpose of this SPA is to amend the provisions governing reimbursement for FQHCs in order to establish an alternative payment methodology (APM) that provides an add-on of $30 per encounter, in addition to the Prospective Payment System (PPS) rate on file for the same date of service.
Approval Date: July 19, 2023
Effective Date: July 20, 2023

South Carolina
This Supplemental Teaching Physician (STP) Payment Program state plan amendment updates the base year used to determine payments under the Average Commercial Rate (ACR) method.
Approval Date: July 19, 2023
Effective Date: April 1, 2023

Mississippi
This amendment proposes to allow the Division of Medicaid (DOM) to revise the education and experience requirements for Early Intervention case managers, effective April 1, 2023.
Approval Date: July 19, 2023
Effective Date: April 1, 2023
Topics: Program Administration

Oklahoma
This state plan amendment increases rates for private duty nursing staff.
Approval Date: July 18, 2023
Effective Date: May 12, 2023