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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 4431 - 4440 of 15693

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

Utah
Effective July 1, 2021, this amendment updates the utilization trend for the outpatient hospital Upper Payment Limit (UPL) in State Fiscal Year 2021. 
Approval Date: August 17, 2021
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

Utah
Effective for services beginning October 1, 2021, this amendment updates the reimbursement methodology for disproportionate share hospital (DSH) payments for federal fiscal year 2022. 
Approval Date: August 17, 2021
Effective Date: October 1, 2021
Topics: Financing & Reimbursement

New Jersey
Updates the fee rates for 2021 including an increase for certified nurse midwives
Approval Date: August 17, 2021
Effective Date: January 1, 2021
Topics: Financing & Reimbursement

Oklahoma
Effective July 1, 2021, this amendment updates Oklahoma's Alternative Benefit Plan (ABP) to remove the 24-day visit limitation for inpatient physician services, adds Medication Assistive Treatment (MAT) services, and enhances dental services for adults.
Approval Date: August 17, 2021
Effective Date: July 1, 2021

Nebraska
Effective October 1, 2020 until September 30, 2025, this amendment adds medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan. 
Approval Date: August 16, 2021
Effective Date: October 1, 2020
Topics: Benefits State Plan Amendment Requirement

Connecticut
Effective August 6, 2021, this amendment adds the optional eligibility group of individuals who are eligible for state plan home and community-based services (HCBS) and meet the requirements for an approved section 1915(c) waiver. The amendment also offers a Medicaid eligibility pathway to certain individuals who meet the coverage requirements for the Connecticut Housing Engagement and Support Services (CHESS) Initiative State Plan Home and Community-Based Services Benefit Pursuant to Section 1915(i) of the Social Security Act. 
Approval Date: August 16, 2021
Effective Date: August 16, 2021

Georgia
Effective August 14, 2020, this amendment creates a 1 percent rate increase for certain primary care codes. 
Approval Date: August 16, 2021
Effective Date: August 14, 2020
Topics: Financing & Reimbursement

Maine
Effective September 6, 2017 this amendment updates the rates for personal care services.
Approval Date: August 16, 2021
Effective Date: September 6, 2017
Topics: Financing & Reimbursement

Georgia
Effective for services beginning January 1, 2021, this amendment adds Silver Fluoride Diamine (HCPCS Code D1354) as a covered service. 
Approval Date: August 16, 2021
Effective Date: January 1, 2021
Topics: Benefits Coverage Dental