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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 5631 - 5640 of 15690

South Carolina
Proposes to update the current Medicaid nursing facility rates for all private and non-state owned governmental facilities by providing for a COVID-19 4% add-on to assist and reimburse nursing facilities for the unanticipated costs incurred in their response to its coronavirus protection of residents as well as facility staff
Approval Date: April 21, 2020
Effective Date: March 1, 2020
Topics: Disaster Relief Financing & Reimbursement

New Hampshire
Updates the allowance for a 3.1% increase to prosthetic devices, durable medical equipment and supplies, and
eyeglass rates
Approval Date: April 21, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

New Hampshire

updates the allowance for a 3.1% increase in extended services to pregnant women and personal care reimbursement rates

Approval Date: April 21, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Maine
streamlines the eligibility process by implementing MAGI-like methodologies for pregnant women, children and parent-caretaker relatives under MNIL
Approval Date: April 21, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

New Hampshire

updates the allowance for a 3.1% increase to the hospice and freestanding birth rates.

Approval Date: April 21, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Colorado
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing, and waive cost-sharing for testing services, testing-related services, and treatments for COVID-19.
Approval Date: April 21, 2020
Effective Date: March 1, 2020
Topics: Cost Sharing Disaster Relief Eligibility

Louisiana
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing, suspend all cost sharing, extend all prior authorization by automatic renewal without clinical review or time/quantity extensions, expand telehealth, adjust prior authorizations for medications, and increase certain payment rates.
Approval Date: April 20, 2020
Effective Date: March 1, 2020
Topics: Benefits Cost Sharing Disaster Relief Eligibility Financing & Reimbursement Prescription Drugs

Minnesota

This SPA 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: April 20, 2020
Effective Date: October 1, 2019
Topics: Drug Utilization Review (DUR)

California
Updates the rates for Radiological services to pay no more than 80% of the corresponding Medicare Physician Fee Schedule rate
Approval Date: April 20, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Louisiana
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing, suspend all cost sharing, extend all prior authorization by automatic renewal without clinical review or time/quantity extensions, expand telehealth, adjust prior authorizations for medications, and increase certain payment rates.
Approval Date: April 20, 2020
Effective Date: March 1, 2020
Topics: Benefits Cost Sharing Disaster Relief Eligibility Financing & Reimbursement Prescription Drugs