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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 3611 - 3620 of 15689

South Carolina
Increase rates for certain incontinence supplies, Substance Abuse and Addictive Disorder
services, autism spectrum disorder (ASD) services, and peer support services.
Approval Date: May 4, 2022
Effective Date: January 1, 2022
Topics: Medical Supplies & Devices

Connecticut
Allows reimbursement changes for private intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs). Specifically, this SPA provides specified fair rent increases and implements a rate increase of 4.3% to pay for costs of wage and benefit enhancements.
Approval Date: May 4, 2022
Effective Date: July 1, 2022
Topics: Financing & Reimbursement

California
This SPA amends the Alternative Benefit Plan (ABP) to restore comprehensive adult optional dental benefits, subject to medical necessity and utilization controls, for eligible adults. This SPA aligns the ABP with the restoration of adult optional dental benefits in the State Plan under the approval of SPA 17-0027.
Approval Date: May 3, 2022
Effective Date: January 1, 2018
Topics: Alternative Benefit Plan

Texas
This SPA amends to implement changes to state law meant to further the use of telemedicine and telehealth by allowing the option to receive certain services using an audio-only platform.
Approval Date: May 3, 2022
Effective Date: February 1, 2022

Oklahoma
This amendment updates the frequency of Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) dental oral prophylaxis services from eve1y 184 days to eve1y six months.
Approval Date: May 3, 2022
Effective Date: September 1, 2022

Arkansas
This amendment proposes allows pharmacists to enroll individually as atypical providers to prescribe and administer specified drugs, and test and screen for certain health conditions.
Approval Date: May 3, 2022
Effective Date: June 1, 2022

Connecticut
Effective January 1, 2022 this amendment proposes  to add mandatory coverage of routine patient costs furnished in connection with participation in qualifying clinical trials.
Approval Date: May 3, 2022
Effective Date: January 1, 2022

California
Updates to the Skilled Nursing Facility Quality and Accountability Supplement Payment (QASP) for the rate period from January 1, 2022 to December 31, 2022.
Approval Date: May 3, 2022
Effective Date: January 1, 2022

Maine
Sets a new rate exception for Southern Maine Health Care, updates the supplemental payment pool for inpatient hospital services, and updates a supplemental payment pool for certain other hospital classes.
Approval Date: May 3, 2022
Effective Date: October 1, 2021
Topics: Program Administration

Washington
Updates references to the 3M APR-DRG software grouper used to group hospital claims for payment.
Approval Date: May 3, 2022
Effective Date: May 1, 2022