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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 3971 - 3980 of 15755

Montana
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 effective April 1, 2021, add single case agreement language to inpatient hospital out of state provider payment methodology. Effective July 1, 2021, it also adds reimbursement for Crisis Assessment services conducted after hours.
Approval Date: February 2, 2022
Effective Date: April 1, 2021
Topics: Disaster Relief Reimbursement

Washington
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 enable the State to receive federal Medicaid matching funds for fee-for-service COVID-19-related supplemental payments to Small Rural Disproportionate Share Hospitals (SRDSH).
Approval Date: February 2, 2022
Effective Date: March 1, 2020
Topics: Disaster Relief Reimbursement

Oklahoma
Revises the language describing the methodology used to calculate the capitation rate payment for PACE organizations. The SPA will remove the Medicare Economic Index ( MEI) adjustment from the rate methodology, as the PACE capitation rate is based on the amount that would otherwise be paid (AWOP) which is reviewed annually and adjusted as needed, without regard to the MEI.
Approval Date: February 2, 2022
Effective Date: November 3, 2021
Topics: Benefits Program Administration

Washington
The purpose of this SPA is regarding Medicare cost reports. This SPA clarifies that HCA requirements to audit the cost report data used for rate setting. The SPA also clarifies that any HCA division with audit authority will audit hospital billings, as well as other financial and statistical records, and rebase the Medicaid payment system on a periodic basis. 
Approval Date: February 2, 2022
Effective Date: October 1, 2021
Topics: Financing & Reimbursement

Ohio
The proposed amendment to Attachments 4.19-A and 4.19-B of your Medicaid State plan submitted under transmittal number 21-0032 titled "Value-Based Purchasing: Suspending Episode-Based Payments Program for Calendar Year 2022.
Approval Date: February 2, 2022
Effective Date: January 1, 2022
Topics: Financing & Reimbursement

Nebraska
This amendment updates Inpatient Provider Rates for SFY 2022.  
Approval Date: February 2, 2022
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

Oregon
This amendment continues the increase to nursing facility ventilator rates at 235% of the base after the end of the public health emergency. 
Approval Date: February 2, 2022
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

Minnesota
This plan amendment makes changes to payments methods for Durable Medical Equipment (DME) to align with requirements under state law.
Approval Date: February 2, 2022
Effective Date: October 15, 2021
Topics: Financing & Reimbursement

Louisiana
Amends the provisions governing the targeted case management program and to update language to reflect current practices.
Approval Date: February 2, 2022
Effective Date: August 20, 2021
Topics: Program Administration

Nebraska
Updates Inpatient Provider Rates for SFY 2022.
Approval Date: February 2, 2022
Effective Date: July 1, 2021
Topics: Program Administration Reimbursement