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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 5341 - 5350 of 15693

Colorado
Changes from paying licensed pharmacists individually for Medication Therapy Counseling to contracting with an entity to run the program, and updates program requirements and restrictions.
Approval Date: August 12, 2020
Effective Date: August 1, 2020
Topics: Program Administration

Nevada

Updates to add a new §1915(i) Home and Community-based Services (HCBS) benefit.

Approval Date: August 11, 2020
Effective Date: July 1, 2020

South Dakota
Provides separate reimbursement of high cost prescription drugs outside of the IHS/Tribal encounter rate
Approval Date: August 11, 2020
Effective Date: April 1, 2020
Topics: Prescription Drugs Reimbursement

Arkansas
increases access to medications for Arkansas Medicaid members with opioid use disorder and removes prior authorization requirements for Medication Assisted Treatment
Approval Date: August 11, 2020
Effective Date: August 1, 2020
Topics: Prescribed Drugs Program Administration

New Jersey
Updates New Jersey Medicaid fee for service rates for long term residential substance abuse services
Approval Date: August 10, 2020
Effective Date: June 4, 2020
Topics: Financing & Reimbursement Program Administration

District of Columbia
Authorizes the District to enroll approximately 19,000 District individuals, who are currently assessing their benefits via fee-for-service, into Medicaid managed care
Approval Date: August 10, 2020
Effective Date: October 1, 2020
Topics: Program Administration

New York
Provides quarterly supplemental payments to one hospital
Approval Date: August 10, 2020
Effective Date: April 1, 2020
Topics: Program Administration

New York
provides quarterly supplemental payments to one hospital
Approval Date: August 10, 2020
Effective Date: April 1, 2020

Missouri
Diabetes Prevention Program Services for Adults.
Approval Date: August 7, 2020
Effective Date: September 1, 2020

Colorado
Proposes to update the pharmaceutical rate methodology by including National Average Drug Acquisition (NADAC) and Maximum Allowable Cost (MAC) into the lesser of logic methodology. 
Approval Date: August 7, 2020
Effective Date: October 1, 2020
Topics: Financing & Reimbursement