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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 4421 - 4430 of 15693

New York
This SPA authorizes temporary rate adjustments for the outpatient services for specific essential community hospital providers.
 
Approval Date: August 20, 2021
Effective Date: April 1, 2021
Topics: Financing & Reimbursement

California
Allows for the continuation of an add-on to the fee-for-service (FFS) fee schedule rates for eligible ground emergency medical transports (GEMT) provided to Medi-Cal patients. 
Approval Date: August 20, 2021
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

South Dakota
Revises the qualifying criteria for traumatic brain injury or spinal cord injury addon payment for individuals residing in a nursing facility. In addition, it allows flexibility for individuals to qualify for this add-on payment in circumstances where completing an actual rehabilitation program is not appropriate.
Approval Date: August 20, 2021
Effective Date: June 1, 2021

Virginia
adds a supplemental payment for freestanding children's hospitals
Approval Date: August 20, 2021
Effective Date: May 15, 2021
Topics: Program Administration

Tennessee
This amendment proposes to add payment methodology for COVID-19 vaccine administration.
Approval Date: August 19, 2021
Effective Date: February 6, 2021
Topics: Financing & Reimbursement

Utah
This State Plan Amendment updates the Durable Medical Equipment (DME) fee schedule
Approval Date: August 19, 2021
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

Maine
This plan amendment updates the payment rates for private duty nursing services, updates the combined payment caps for private duty nursing and personal care service.
Approval Date: August 19, 2021
Effective Date: January 1, 2018
Topics: Financing & Reimbursement

Georgia
This plan amendment adds a three percent increase to 15 select dental codes. 
Approval Date: August 19, 2021
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

Connecticut
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to remove the limit on the number of home and hospital bed leave days for which an ICF/IID can be paid in order to reserve the beds for when the individuals are able to return to the ICF/IID. This SPA also rescinds the flexibility approved in SPA CT-20-0015 that allowed PNMIs for adults to conduct only one random-moment time study (RMTS).
Approval Date: August 18, 2021
Effective Date: April 28, 2021
Topics: Benefits Disaster Relief Reimbursement

Virginia

Effective July 1, 2021, this amendment allows for 12-month contraception dispensing and participation in the National Medicaid Pooling Initiative (NMPI). 

Approval Date: August 18, 2021
Effective Date: July 1, 2021
Topics: Benefits Contraceptive Drugs