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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 5541 - 5550 of 15691

Connecticut
Incorporates various 2020 Healthcare Common Procedure Coding System (HCPCS) updates (additions, deletions and description changes) to the Physician Office & Outpatient, Physician-Radiology, Physician-Surgery, and Psychology fee schedules. In addition, there are updates to the reimbursement methodology for specified drugs in order to comply with the approved Medicaid State Plan methodology for physician-administered drugs
Approval Date: May 22, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement Prescription Drugs

Minnesota
Adds income and resource disregards to certain individuals eligible for home and community-based waiver services under Section 1915c of the Social Security Act..
Approval Date: May 22, 2020
Effective Date: October 1, 2019

Nevada
This amendment is to update the needs-based criteria; update who can perform evaluations and re-evaluations of 1915(i) eligibility; update language related to the CMS HCBS settings requirements; update who can perform the person-centered planning assessment; revise services covered under Habilitation services; and update reimbursement pages.
Approval Date: May 22, 2020
Effective Date: March 1, 2020
Topics: Benefits Eligibility Financing & Reimbursement Program Administration

Tennessee
Proposes to authorize the state to transfer all of the drugs on the Prescriber Attestation List to the Automatic Exemption List
Approval Date: May 22, 2020
Effective Date: March 1, 2020

Connecticut
Incorporates the 2020 Healthcare Common Procedure Coding System (HCPCS) changes (additions, deletions and description changes) to the Independent Radiology and Independent Laboratory fee schedules
Approval Date: May 22, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Michigan
Provide authority to establish an Outpatient Prospective Payment System (OPPS) reduction factor specifically for Critical Access Hospitals (CAHs) to increase OPPS payment
Approval Date: May 21, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Iowa
Increase the premiums assessed to individuals enrolled in the eligibility group under section 1902(a)(10)(A)(ii)(XIII) of the Social Security Act beginning on August 1, 2020
Approval Date: May 21, 2020
Effective Date: August 1, 2020

Georgia
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to provide flexibilities for presumptive eligibility, suspend all copayments, allow telehealth and provide an associated payment methodology, allow brand name products if generic prescription drugs are unavailable from the preferred drug list, and make interim payments to skilled nursing facilities.
Approval Date: May 20, 2020
Effective Date: March 1, 2020
Topics: Benefits Cost Sharing Disaster Relief Eligibility Financing & Reimbursement Prescription Drugs

Colorado
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to provide flexibilities in the areas of home health, transportation, telemedicine, inpatient hospital services, and pharmacy benefits.
Approval Date: May 20, 2020
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief Prescription Drugs

Northern Mariana Islands
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing, continue to consider residents who leave the Territory due to the disaster residents of the Territory, extend the reasonable opportunity period, allow 90-day supplies of drugs and early refills, extend all prior authorizations for medications without clinical review, or time/quantity extensions, allow exceptions to the Territory's preferred drug list in case of shortages, and allow use of telehealth methods in lieu of face-to-face reimbursed at 80% of the face-to-face rate.
Approval Date: May 20, 2020
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief Eligibility Financing & Reimbursement Prescription Drugs