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 4801 - 4810 of 15690

Texas
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to allow the use of an alternate random moment time study (RMTS) for reimbursement of School Health and Related Services in the event of a state of emergency, such as the COVID-19 public health crisis, that causes any quarter in the RMTS to become statistically invalid.
Approval Date: April 8, 2021
Effective Date: April 1, 2020
Topics: Disaster Relief Reimbursement

West Virginia
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to increase payment rates for durable medical equipment, dental services, ambulance services, physical therapy, occupational therapy, speech therapy, intermediate care facilities, and personal care services. The payment increases are effective from July 1, 2020 through December 31, 2020.
Approval Date: April 8, 2021
Effective Date: July 1, 2020
Topics: Disaster Relief Reimbursement

Kansas
Effective January 01, 2021, this amendment removes an incorrect acronym used in describing the provider qualifications for the Individual Intensive Supports service. The change does not alter the provider qualifications themselves.
Approval Date: April 8, 2021
Effective Date: January 1, 2021
Topics: Data Definition Update

Alaska
Effective January 01, 2021, this amendment updates the optional state supplement program's annual income standards consistent with the federal register.
Approval Date: April 8, 2021
Effective Date: January 1, 2021
Topics: Financing & Reimbursement Program Administration

North Dakota
Effective January 1, 2021, this amendment provides a 2.5 percent inflationary increase for Psychiatric Residential Treatment Facility (PRTF) services, for services on or after the effective date.
Approval Date: April 7, 2021
Effective Date: January 1, 2021
Topics: Financing & Reimbursement

North Dakota
Effective January 1, 2021, this amendment implements a 2.5 percent inflationary increase for nursing facility services
Approval Date: April 7, 2021
Effective Date: January 1, 2021
Topics: Financing & Reimbursement

Wyoming
Effective January 1, 2021, this amendment clarifies how the payments are calculated for rehabilitative services.
Approval Date: April 6, 2021
Effective Date: January 1, 2021
Topics: Benefits Financing & Reimbursement

Oregon
Effective January 7, 2021, this amendment increases the daily encounter limit from one encounter per day to five encounters per day. This change applies to Indian Health Service and Tribal 638 clinics.
Approval Date: April 5, 2021
Effective Date: January 7, 2021
Topics: Benefits Indian Health Services Program Administration

California
Effective July 1, 2021, this amendment updates the Current Dental Terminology dental code set to CDT 2020, replacing the CDT 2019 code set. 
Approval Date: April 2, 2021
Effective Date: July 1, 2021
Topics: Dental Financing & Reimbursement

Oklahoma
Effective January 1, 2021, this amendment updates the reimbursement methodology for tribal providers rendering residential substance use disorder (SUD) services.
Approval Date: April 2, 2021
Effective Date: January 1, 2021
Topics: Financing & Reimbursement Tribal Issues