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 5481 - 5490 of 15693

Kansas
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to authorize a supplemental payment of $20/day to nursing facilities. These payments will be retroactive to March 13 and will expire after 120 days or on the day the public health emergency ends, whichever occurs first.
Approval Date: June 11, 2020
Effective Date: March 13, 2020
Topics: Disaster Relief Financing & Reimbursement

California
Current Dental Terminology (CDT) dental code set update for procedures also receiving supplemental payments from proposition 56 funding.
Approval Date: June 11, 2020
Effective Date: March 14, 2020
Topics: Dental Financing & Reimbursement Program Administration

Connecticut
Adds the procedure codes and changes the repair payment methodology to the lesser of Manufacturer’s Suggested Retail Price (MSRP) minus 15% or Actual Acquisition Cost (AAC) plus a percentage as described below (except complex rehab technology (CRT) which will continue to be paid at list price minus 18% including repairs)
Approval Date: June 11, 2020
Effective Date: March 1, 2020
Topics: Financing & Reimbursement

Connecticut
Increases the rate for Liletta, a Long-Acting Reversible Contraceptive device (LARC), code J7297 (Liletta, 52 mg) to $100 on the Family Planning Clinic fee schedule, which is necessary to reimburse providers for the device’s increased acquisition cost. This SPA also removes code 90461 - Immunization administration from the Medical Clinic fee schedule to ensure accurate billing based on national definitions.
Approval Date: June 11, 2020
Effective Date: March 1, 2020
Topics: Financing & Reimbursement

Ohio
Managed care: Removal of Obsolete Pages
Approval Date: June 11, 2020
Effective Date: April 1, 2020

Arkansas
Increases rates for day habilitation services and to make corrections to the related coverage pages
Approval Date: June 11, 2020
Effective Date: January 1, 2020
Topics: Benefits Financing & Reimbursement

New York
updates and extends the fee schedules associated with Independent Practitioner Services for Individuals with Developmental Disabilities (IPSIDD).
Approval Date: June 10, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Arkansas
rate increase for ambulance services
Approval Date: June 10, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

Puerto Rico
Allows Puerto Rico to cover MAVYRET, a Hepatitis C drug
Approval Date: June 10, 2020
Effective Date: March 16, 2020
Topics: Financing & Reimbursement

New York
Adds additional exempt groups from Medicaid copays
Approval Date: June 9, 2020
Effective Date: October 1, 2015
Topics: Individual CoPayments or Insurance Payments