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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 4821 - 4830 of 15693

Utah
Effective 02/01/2021 for a two-year period only, with a termination date of 01/31/2023,this amendment provides an exception to the Medicaid Recovery Audit Contractor program.
Approval Date: April 1, 2021
Effective Date: February 1, 2021
Topics: Financing & Reimbursement Managed Care Program Integrity

Ohio
Effective 1/1/21 this SPA rescinds the temporary expansion of Prior Authorization (PA) for medications that allowed automatic renewal of PA without clinical review or time/quality extensions, which was approved in Disaster Relief SPA OH-20-0012 in response to the COVID-19 Public Health Emergency (PHE).
Approval Date: March 31, 2021
Effective Date: January 1, 2021
Topics: Benefits Disaster Relief

Ohio
Effective 1/1/21 this SPA rescinds the temporary increase in the maximum number of bed hold days available for Nursing Facility (NF) and Intermediate Care Facility (ICF) residents from 30 days per calendar year to 60 days per calendar year, which was approved in OH-20-0012 in response to the COVID-19 Public Health Emergency (PHE).
Approval Date: March 31, 2021
Effective Date: January 1, 2021
Topics: Disaster Relief Reimbursement

Montana
Effective March 18, 2020, the agency rescinds the election at A.1. of section 7.4 (approved on May 8, 2020 in SPA Number MT-20-0024) of the state plan to furnish medical assistance to the optional eligibility group.
Approval Date: March 31, 2021
Effective Date: March 18, 2020
Topics: Disaster Relief Eligibility

Ohio
Effective 1/5/21 this State Plan Amendment rescinds the temporary suspension of beneficiary copayments that was approved in DR SPA OH-20-0012 in response to the COVID-19 Public Health Emergency (PHE).
Approval Date: March 31, 2021
Effective Date: January 5, 2021
Topics: Disaster Relief Eligibility

Ohio
This SPA rescinds the temporary Presumptive Eligibility (PE) flexibilities, approved in Disaster Relief SPA OH-20-0012 in response to the COVID-19 Public Health Emergency (PHE), which expanded the populations for which PE determinations could be made.
Approval Date: March 31, 2021
Effective Date: January 1, 2021
Topics: Disaster Relief Eligibility

Kentucky
To revise reimbursement for ground ambulance providers licensed as Class I-III to make interim and final supplemental payments
Approval Date: March 31, 2021
Effective Date: January 1, 2021

New Jersey
Amendment to update Medicaid Fee Schedules for Adult Day Health and Private Duty Nursing Rates
Approval Date: March 30, 2021
Effective Date: October 1, 2020
Topics: Financing & Reimbursement

New Jersey
This amendment adds a COVID-19 Administration Fee
Approval Date: March 30, 2021
Effective Date: December 19, 2020
Topics: Financing & Reimbursement Program Administration

New York
This amendment clarifies the existing methodology for distribution of the rural enhancement for personal care services. 
Approval Date: March 30, 2021
Effective Date: July 1, 2020
Topics: Federal Financial Match Program Administration