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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 4811 - 4820 of 15689

New Hampshire
Effective July 1, 2020, this amendment revises the quarterly nursing home supplemental payment (also known as MQIP), for dates of service in the quarter ending September 30, 2020. 
Approval Date: April 2, 2021
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Texas
Effective July 1, 2020, this amendment implements a reimbursement methodology for when a new national procedure code is assigned for HealthCare Common Procedure Coding System (HCPCS) updates and when federally-mandated reimbursement rates, physician-administered drugs (PADs), or biological products are released. 
Approval Date: April 2, 2021
Effective Date: July 1, 2020
Topics: Financing & Reimbursement Program Administration

Iowa
Ubillpdates the billing code for the Health Promotion services.  The change is being made to align with the current Medicare billing code for that service
Approval Date: April 1, 2021
Effective Date: January 1, 2021

Kansas
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to add pharmacy interns and techs to the providers who can administer vaccines. It also notes that the State will follow current vaccine administration reimbursement methodology for interns and techs, paying $14.15 per vaccine administration.
Approval Date: April 1, 2021
Effective Date: December 1, 2020
Topics: Benefits Disaster Relief Reimbursement

Oklahoma
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to add nurse practitioners, clinical nurse specialists, and physician assistants to order home health as per the CARES Act.
Approval Date: April 1, 2021
Effective Date: March 27, 2020
Topics: Benefits Disaster Relief

North Dakota
Effective 04/01/2021, this amendment extends the exemption for a Recovery Audit Contractor. 
Approval Date: April 1, 2021
Effective Date: April 1, 2021
Topics: Financing & Reimbursement Managed Care

Utah
Effective 02/01/2021 for a two-year period only, with a termination date of 01/31/2023,this amendment provides an exception to the Medicaid Recovery Audit Contractor program.
Approval Date: April 1, 2021
Effective Date: February 1, 2021
Topics: Financing & Reimbursement Managed Care Program Integrity

Ohio
Effective 1/1/21 this SPA rescinds the temporary expansion of Prior Authorization (PA) for medications that allowed automatic renewal of PA without clinical review or time/quality extensions, which was approved in Disaster Relief SPA OH-20-0012 in response to the COVID-19 Public Health Emergency (PHE).
Approval Date: March 31, 2021
Effective Date: January 1, 2021
Topics: Benefits Disaster Relief

Ohio
Effective 1/1/21 this SPA rescinds the temporary increase in the maximum number of bed hold days available for Nursing Facility (NF) and Intermediate Care Facility (ICF) residents from 30 days per calendar year to 60 days per calendar year, which was approved in OH-20-0012 in response to the COVID-19 Public Health Emergency (PHE).
Approval Date: March 31, 2021
Effective Date: January 1, 2021
Topics: Disaster Relief Reimbursement

Montana
Effective March 18, 2020, the agency rescinds the election at A.1. of section 7.4 (approved on May 8, 2020 in SPA Number MT-20-0024) of the state plan to furnish medical assistance to the optional eligibility group.
Approval Date: March 31, 2021
Effective Date: March 18, 2020
Topics: Disaster Relief Eligibility