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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 3861 - 3870 of 15696

Hawaii
Removes the application of the routine cost limit and customary charge limit for cost reimbursement of distinct part nursing facilities of critical access hospitals.
Approval Date: February 21, 2022
Effective Date: January 1, 2022
Topics: Program Administration

Oregon
Adds a new licensed provider type (dental therapists) to the Oregon State Plan.
Approval Date: February 18, 2022
Effective Date: January 1, 2022
Topics: Benefits Program Administration

Kansas

Increases the reimbursement rates for global pregnancy services

Approval Date: February 18, 2022
Effective Date: January 1, 2022

Kentucky
an extension of our approved exception to establishing a recovery audit contractor. In 2019, CMS approved KY SPA 19-006, which approved an exception through April 1, 2022.
Approval Date: February 17, 2022
Effective Date: April 1, 2022
Topics: Program Administration

Missouri
Updates prescribing providers for preventive services from only physicians to license practitioners within the scope of their license which is in line with industry standards and federal language.
Approval Date: February 16, 2022
Effective Date: April 1, 2022
Topics: Program Administration

North Dakota
Updates to Third Party Liability activities to comply with
federal regulations.
Approval Date: February 16, 2022
Effective Date: October 1, 2021
Topics: Program Administration

South Carolina
Brings the State Plan into compliance with the TPL requirements under the BBA of 2018 and the MSIAA of2019.
Approval Date: February 16, 2022
Effective Date: December 31, 2021
Topics: Program Administration

Nebraska
Requests a waiver extension to the Federal requirements for implementing a Recovery Audit Contractor (RAC) program.
Approval Date: February 15, 2022
Effective Date: December 1, 2021
Topics: Program Administration

Wisconsin
The purpose of this SPA is to allow for passive enrollment of BadgerCare Plus and SSI-Related Medicaid beneficiaries, who are required to join a Health Maintenance Organization, effective December 11, 2021.
Approval Date: February 15, 2022
Effective Date: December 11, 2021

Ohio
Authorizes the state to enter in Value-Based Purchasing (VBP) rebate agreements with drug manufacturers for drugs provided under the Medicaid program.
Approval Date: February 14, 2022
Effective Date: December 1, 2021
Topics: Program Administration