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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 361 - 370 of 15689

California

This amendment will align the Medicaid State Plan with federal law for prior authorizations and prompt payment and will bring California into compliance with the Consolidated Appropriations Act of 2022 (Public Law 117-103). 

Approval Date: December 11, 2024
Effective Date: January 1, 2025

Iowa

This amendment adds Therapeutic Foster Care to Iowa’s Medicaid State Plan as a Rehabilitative Service.

Approval Date: December 11, 2024
Effective Date: July 1, 2024
Topics: Coverage and Reimbursement

Wisconsin

This SPA allows Wisconsin to enter into Value-Based Supplemental Rebate Agreements with drug manufacturers on a voluntary basis.

Approval Date: December 11, 2024
Effective Date: July 1, 2024
Topics: Value Based Purchasing

Kansas

This SPA allows coverage of medically necessary prescribed drugs that are not covered outpatient drugs, including drugs authorized for import by the U.S. Food and Drug Administration (FDA), during drug shortages. Additionally, this SPA authorizes reimbursement of prescribed drugs that are not considered covered outpatient drugs, with the same reimbursement methodologies as covered outpatient drugs.

Approval Date: December 11, 2024
Effective Date: October 1, 2024
Topics: Drug Shortages Reimbursement

Utah

This amendment changes to reimbursement methods for ultra-high-cost drugs.

Approval Date: December 10, 2024
Effective Date: April 29, 2024

Arkansas

This plan amendment updates the rates for specialized formula and associated supplies.

Approval Date: December 10, 2024
Effective Date: August 1, 2024

Oklahoma

This amendment extends the exception for the Recovery Audit Contractor (RAC) Program for an additional two-year period.

Approval Date: December 10, 2024
Effective Date: April 1, 2024
Topics: Program Administration

Kansas

This amendment discontinues health homes from the alternative benefit plan.

Approval Date: December 10, 2024
Effective Date: January 1, 2025
Topics: Alternative Benefit Plan

Kansas

This amendment discontinues health homes from the Supports and Training for Employing People Successfully (STEPS) program alternative benefit plan.

Approval Date: December 10, 2024
Effective Date: January 1, 2025
Topics: Alternative Benefit Plan

California

This amendment will implement a Medicare Part A buy-in agreement between the California Department of Health Care Services (DHCS) with CMS.

Approval Date: December 10, 2024
Effective Date: October 1, 2024