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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 4651 - 4660 of 15690

Virginia
Implements Mental Health Intensive Outpatient Programs, a new service for youth and adults; and Mental Health Partial Hospitalization Programs for Youth and Adults, which will replace the current Partial Hospitalization Program for adults
Approval Date: May 27, 2021
Effective Date: July 1, 2021
Topics: Program Administration

Pennsylvania
Effective June 1, 2021 and expiring on May 31, 2023, this amendment provides an exception from the Medicaid Recovery Audit Contractor (RAC) requirements. 
Approval Date: May 27, 2021
Effective Date: June 1, 2021
Topics: Financing & Reimbursement Program Administration Program Integrity

District of Columbia
Effective April 1, 2021, this amendment permits the District of Columbia Medicaid Program to cover transplantation of a kidney or liver from a living donor and related care provided to that living donor. 
Approval Date: May 27, 2021
Effective Date: April 1, 2021
Topics: Benefits Program Administration

New York
Proposes to apply a $2.50 copay to all brand drugs, except when the brand drug cost less than the generic equivalent. The proposed policy will result in a $1.50 increase in copays for some brand name drugs referred to as “preferred” brand name drugs. 
Approval Date: May 27, 2021
Effective Date: January 1, 2021
Topics: Individual CoPayments or Insurance Payments

Georgia
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 increase nursing home per diem to cover increase in cost due to public health emergency for the period 7/1/2020 – 6/30/2021.
Approval Date: May 26, 2021
Effective Date: July 1, 2020
Topics: Disaster Relief Reimbursement

Ohio
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 temporarily suspend the 5% penalty imposed on nursing facilities (NF) for late, inaccurate, or insufficient resident assessment data used in calculating the case mix score.
Approval Date: May 26, 2021
Effective Date: March 1, 2020
Topics: Disaster Relief Reimbursement

Kentucky
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 implement a temporary $29.00 increase in case mix nursing facility per diem rates.
Approval Date: May 26, 2021
Effective Date: January 1, 2021
Topics: Disaster Relief Reimbursement

New Hampshire
This amendment revises the quarterly nursing home supplemental payment, also known as MQIP, for dates of
service in the quarter ending March 31, 2021.
Approval Date: May 26, 2021
Effective Date: January 1, 2021
Topics: Financing & Reimbursement

Washington
Creates a new, cost-based per diem rate for substance use disorder (SUD) residential treatment facilities (RTF) operated by the Indian Health Service (IHS) or Tribes to IHS-eligible American Indian/Alaska Native (AI/AN) Medicaid beneficiaries. 
Approval Date: May 26, 2021
Effective Date: September 12, 2020
Topics: Indian Health Services

New York
New York State Department of Health updates the Outpatient Hospital Upper Payment Limit Demonstration.
Approval Date: May 26, 2021
Effective Date: July 1, 2020
Topics: Financing & Reimbursement