U.S. flag

An official website of the United States government

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 4641 - 4650 of 15690

Illinois
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 cover COVID-19 vaccine administration using the Medicare Suburban Chicago FFS rate statewide and to recognize pharmacies and pharmacy professionals as qualified providers of COVID-19 vaccines per the HHS PREP Act.
Approval Date: May 28, 2021
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief Reimbursement

Washington
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 provide a disregard of certain resources when determining eligibility for individuals that are receiving long-term services and supports under a special income level.
Approval Date: May 28, 2021
Effective Date: November 2, 2020
Topics: Disaster Relief Eligibility

Oregon
Moves Oregon’s current Medication Assisted Treatment (MAT) benefit from the optional benefit section in Oregon’s state plan to the required benefit section to comply with Section 1006(b) of the SUPPORT Act. 
Approval Date: May 28, 2021
Effective Date: October 1, 2020
Topics: Benefits Prescription Drugs

West Virginia
This amendment was submitted in order to clarify the existing clinic services benefit and to add a $1,000 per calendar year dental benefit for adults.  
Approval Date: May 28, 2021
Effective Date: January 1, 2021

Alabama
Effective July 1, 2020, this amendment allows the disregard of Census-based income for certain Non-Modified Adjusted Gross Income (non-MAGI) eligibility groups.
Approval Date: May 28, 2021
Effective Date: July 1, 2020
Topics: Eligibility Program Administration

Tennessee
Effective March 1, 2021, this amendment implements the 1915 (1) State Plan Option that provides Medicaid Assistance for eligible individuals who are patients in eligible institutions for mental diseases (IMD) in accordance with Section 5052 of Public Law 115-271. 
Approval Date: May 28, 2021
Effective Date: March 1, 2021
Topics: Eligibility Program Administration

Northern Mariana Islands
Effective January 1, 2021, this amendment adopts the option to provide Medicaid eligibility without a 5-year waiting period to otherwise eligible individuals who lawfully reside in the Commonwealth of the Northern Mariana Islands in accordance with the Compacts of Free Association (COFA) between the Government of the United States and the Governments of the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau. 
Approval Date: May 28, 2021
Effective Date: January 1, 2021

South Carolina
Effective April 1, 2021, this amendment authorizes supplemental payments for the outpatient services of certain non-government owned or operated general hospitals.
Approval Date: May 28, 2021
Effective Date: April 1, 2021
Topics: Financing & Reimbursement

South Carolina

Creates an Opiod T19-002reatment Program (OTP) Services program requirements and fee schedule rates.

Approval Date: May 28, 2021
Effective Date: January 1, 2019
Topics: Coverage and Reimbursement

Rhode Island
To make the annual update to the Medicaid State Plan to reflect the 1.3% cost-of-living increase for 2021 on the State Supplementary Payments and the Medically Needy Income.
Approval Date: May 28, 2021
Effective Date: January 1, 2021