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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 5901 - 5910 of 15780

Pennsylvania
This SPA continues funding of DSH payments to qualifying MA-enrolled acute care general hospitals that provide a high volume of inpatient services to MA eligible and low income populations. These payments are intended to promote access to medically necessary inpatient services for MA eligible persons. The DHS published notice of its intent to allocate funding for these payments in the Pennsylvania Bulletin on December 21, 2019, at 49 Pa.B. 7541. 
Approval Date: February 25, 2020
Effective Date: December 22, 2019
Topics: Financing & Reimbursement

California
Supplemental payments for Hospital Inpatient Services
Approval Date: February 25, 2020
Effective Date: July 1, 2019
Topics: Financing & Reimbursement

California
Supplemental payments for Hospital Outpatient Services
Approval Date: February 25, 2020
Effective Date: July 1, 2019
Topics: Financing & Reimbursement

California
Supplemental payments for Hospital Inpatient Services
Approval Date: February 25, 2020
Effective Date: July 1, 2019
Topics: Financing & Reimbursement

Louisiana
Requests to amend the provisions governing the public process for managed care organizations (MCOs) by removing language that refers to the utilization of rulemaking to satisfy public comment requirements. The amendment also adds language to require a 30-day public comment period for MCO contract amendments and a 45-day public comment period for policy or procedure changes (unless the Louisiana Department of Health finds that imminent peril to the public's health, safety, or welfare requires immediate approval).
Approval Date: February 24, 2020
Effective Date: January 1, 2020

South Carolina
Updates SC DSH program as well as inpatient hospital payments
Approval Date: February 24, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Montana
The state changes cost sharing (deductibles, co-insurance or co-payments) to individuals covered under Medicaid.
Approval Date: February 24, 2020
Effective Date: January 1, 2020

California
Medi-Cal reimbursement rates for Durable Medical Equipment
Approval Date: February 24, 2020
Effective Date: January 1, 2019

Kansas
Allows the state to comply with the Medicaid Drug Utilization Review (DUR)
provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes
Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271).
Approval Date: February 24, 2020
Effective Date: December 2, 2019
Topics: Program Administration

Oklahoma
To include pancreas and intestinal transplants as covered organ and tissue transplant procedures.  It also updated transplant standards to include donor search and procurement services and to ensure that the methods used for organ acquisition are consistent with the Medicare program
Approval Date: February 24, 2020
Effective Date: January 1, 2020
Topics: Current State Plan Eligibility Program Administration