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 4821 - 4830 of 15689

Ohio
Effective 1/5/21 this State Plan Amendment rescinds the temporary suspension of beneficiary copayments that was approved in DR SPA OH-20-0012 in response to the COVID-19 Public Health Emergency (PHE).
Approval Date: March 31, 2021
Effective Date: January 5, 2021
Topics: Disaster Relief Eligibility

Ohio
This SPA rescinds the temporary Presumptive Eligibility (PE) flexibilities, approved in Disaster Relief SPA OH-20-0012 in response to the COVID-19 Public Health Emergency (PHE), which expanded the populations for which PE determinations could be made.
Approval Date: March 31, 2021
Effective Date: January 1, 2021
Topics: Disaster Relief Eligibility

Kentucky
To revise reimbursement for ground ambulance providers licensed as Class I-III to make interim and final supplemental payments
Approval Date: March 31, 2021
Effective Date: January 1, 2021

New Jersey
Amendment to update Medicaid Fee Schedules for Adult Day Health and Private Duty Nursing Rates
Approval Date: March 30, 2021
Effective Date: October 1, 2020
Topics: Financing & Reimbursement

New Jersey
This amendment adds a COVID-19 Administration Fee
Approval Date: March 30, 2021
Effective Date: December 19, 2020
Topics: Financing & Reimbursement Program Administration

New York
This amendment clarifies the existing methodology for distribution of the rural enhancement for personal care services. 
Approval Date: March 30, 2021
Effective Date: July 1, 2020
Topics: Federal Financial Match Program Administration

New Jersey
This amendment updates 2020 Medicaid Fee Schedules.
Approval Date: March 30, 2021
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Pennsylvania
update the Program of All-Inclusive Care for the Elderly (PACE) Medicaid capitation rate methodology. This SPA transitions from using Fee-for-Service
(FFS) data to using Managed Care for development of the amount that would otherwise have been paid (AWOP) calculation.
Approval Date: March 30, 2021
Effective Date: July 1, 2021

North Carolina
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this COVID - 19 Medicaid Disaster Relief Round 7 State plan amendment is to allow pharmacists to administer vaccines for COVID-19.
Approval Date: March 29, 2021
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief

Massachusetts
This plan amendment updates the methods and standards to set payment rates for acute outpatient hospitals.
Approval Date: March 29, 2021
Effective Date: October 1, 2020
Topics: Financing & Reimbursement