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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 4461 - 4470 of 15693

Missouri
Effective July 20, 2021, this amendment revises the reimbursement methodology for outpatient services.
Approval Date: August 3, 2021
Effective Date: July 20, 2021
Topics: Financing & Reimbursement

Connecticut
Effective April 1, 2021, this amendment updates the DME fee schedule to incorporate the April 2021 Healthcare Common Procedure Coding System (HCPCS) changes to remain compliant with the Health Insurance Portability and Accountability Act (HIPPA). Newly added codes are priced using a comparable methodology to other codes in the same or similar category.
Approval Date: August 3, 2021
Effective Date: April 1, 2021
Topics: Financing & Reimbursement

North Dakota
Effective July 1, 2021, this amendment implements an increase to the professional fee schedule for vaccine administration under the Pediatric Immunization program. 
Approval Date: August 3, 2021
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

South Carolina

This SPA is to include language in the South Carolina State Plan to allow managed care coverage for treatment of beneficiaries in Opioid Treatment Programs and inpatient freestanding psychiatric treatment facilities.

Approval Date: August 3, 2021
Effective Date: January 1, 2019

New York
It eliminates payment for bed reserve days for hospitalizations for all residents aged over 21 years with the exception of persons on hospice and therapeutic leaves. 
Approval Date: August 2, 2021
Effective Date: January 1, 2019
Topics: Financing & Reimbursement

Mississippi
update the state’s rehabilitative services State Plan pages to align with changes made to the state’s behavioral health coverage by the Mississippi Department of Mental Health. Additionally, this amendment proposes to contain rate increases for mental health assessments and establishes payment methodologies for acute partial
hospitalization in the outpatient setting.
Approval Date: August 2, 2021
Effective Date: September 1, 2020
Topics: Benefits Program Administration

Arkansas
Effective August 1, 2021, this amendment corrects an error regarding the required frequency of contacts between targeted case managers and beneficiaries.
Approval Date: August 1, 2021
Effective Date: June 24, 2021
Topics: Current State Plan Program Administration

Pennsylvania
The SPA authorizes an additional class of disproportionate share hospital payments to facilities treating a high number of COVID-19 patients. 
Approval Date: July 30, 2021
Effective Date: May 9, 2021
Topics: Financing & Reimbursement

Pennsylvania
SPA authorizes a new supplemental payment to facilities treating a high volume of patients under the age of 18. 
Approval Date: July 30, 2021
Effective Date: June 20, 2021
Topics: Financing & Reimbursement

Michigan
Establishes the payment methodology for COVID-19 vaccine administration.
Approval Date: July 29, 2021
Effective Date: January 1, 2022