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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 2201 - 2210 of 15696

Ohio
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to implement a one-time provider relief payment to dialysis centers. These payments are not a component of the HCBS ARP spending plan.
Approval Date: June 21, 2023
Effective Date: April 1, 2023
Topics: Disaster Relief Reimbursement

Massachusetts

This SPA is to update the CarePlus Alternative Benefit Plan (ABP) to revise the prior authorization requirements for home health nursing, home health aide services, and home health therapy services, and remove the scope limitations on home health aide services.

Approval Date: June 21, 2023
Effective Date: January 1, 2023
Topics: Home Health Prior Authorization

Michigan
To adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Approval Date: June 20, 2023
Effective Date: January 1, 2023

Ohio

To adopt new income and resource disregards, authorized under section 1902(r)(2)(A) of the Social Security Act, for the eligibility determinations of the non-MAGI groups covered under the state plan.

Approval Date: June 20, 2023
Effective Date: April 1, 2023

Washington
This amendment will bring the Alternative Benefit Plan (ABP) into alignment with changes that have already been in the Medicaid State Plan.
Approval Date: June 20, 2023
Effective Date: April 1, 2022
Topics: Alternative Benefit Plan

Guam
This amendment clarifies the assurance that Guam provides EPSDT services pursuant to sections 1902(a)(10)(A), 1905(a)(4)(B), and 1905(r) of the Social Security Act.
Approval Date: June 20, 2023
Effective Date: January 1, 2023

Utah
The purpose of this SP A is to provide language to facilitate reimbursement for pharmacist cognitive services such as MTM services and contraceptive prescribing.
Approval Date: June 20, 2023
Effective Date: January 1, 2023

Maine
This BHH SPA amendment updates the reimbursement plan pages to identify two distinct PMPM rates: an adult PMPM rate and a child PMPM rate. This was due to in part a recently completed rate study performed by a contracted vendor for MaineCare Rate System Reform codification.
Approval Date: June 20, 2023
Effective Date: January 1, 2023
Topics: Health Homes Reimbursement

Michigan
Provides an update to the TCM State Plan Amendment C (aging) changing references of “in person” to “face to face” as face-to-face encompasses both in-person and telehealth which allows for more flexibility to assist individuals eligible under the State Plan.
Approval Date: June 16, 2023
Effective Date: May 12, 2023
Topics: Targeted Case Management

Maryland
To reimburse for community violence prevention services. Coverage will be extending to this service at a fee-for-service rate of $32.76 per 30-minute increments up to a maximum of 100 increments in a rolling 12-month period.
Approval Date: June 16, 2023
Effective Date: July 1, 2023
Topics: Coverage Reimbursement