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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 5051 - 5060 of 15692

Oklahoma
This SPA describes the methodology used by the state for determining the appropriate FMAP rate, including any increased FMAP rates, available under the provisions of the Affordable Care Act applicable for the medical assistance expenditures under the Medicaid program associated with adult group enrollees adopted by the state in SPA 21-0001.
Approval Date: December 4, 2020
Effective Date: July 1, 2021
Topics: Benefits Eligibility Financing & Reimbursement

Oklahoma
This SPA establishes the benefits and services that will serve as the Alternative Benefit Package (ABP) that will be available to Oklahoma’s adult group. Oklahoma’s ABP for the adult group will include the same services that are traditionally available to categorically needy individuals under the state’s approved State plan. The population group for this ABP includes only the adult group.
 
Approval Date: December 4, 2020
Effective Date: July 1, 2021
Topics: Benefits Eligibility Financing & Reimbursement

Oklahoma
adds an Alternative Benefit Plan (ABP) to Oklahoma’s State Plan to cover the Medicaid Expansion Population
Approval Date: December 4, 2020
Effective Date: July 1, 2021
Topics: Benefits Program Administration

Oklahoma
Establish methodology to claim the appropriate FMAP rate for individuals enrolled in the new adult group
Approval Date: December 4, 2020
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

California
Adds licensed midwives to the Alternative Benefit Plan (ABP) section of the state plan. 
Approval Date: December 3, 2020
Effective Date: July 1, 2015

Ohio
Value-Based Purchasing: Suspending Episode-Based Payments Program for program years 2020 and 2021
Approval Date: December 3, 2020
Effective Date: September 1, 2020
Topics: Program Administration

Michigan
establishes Alternative Benefit Plan(ABP) MI uses to implement requirements of the Healthy Michigan Plan(HMP)
Approval Date: December 3, 2020
Effective Date: August 1, 2020
Topics: Benefits Program Administration

Michigan
Implements new federal regulations to permit non-physician practitioners (e.g., nurse practitioners, physician assistants, and clinical nurse specialist) to order home health services and durable medical equipment.
Approval Date: December 3, 2020
Effective Date: August 1, 2020
Topics: Program Administration

South Carolina

This SPA includes reimbursement methods that use, among others, the National Average Drug Acquisition Cost (NADAC), plus a professional dispensing fee of $10.50 for covered outpatient drugs. This SPA also includes reimbursement rates for 340B drugs, long-term care and specialty drugs, drugs purchased at a nominal price, and physician administered drugs.

Approval Date: December 3, 2020
Effective Date: July 15, 2020
Topics: Covered Outpatient Drug Reimbursement

Virginia
This amendment establishes an additional disporportionate share hospital payment to non-state government owned acute care hospitals and applies nursing facility inflation rates to specialized care facilities. 
Approval Date: December 2, 2020
Effective Date: July 1, 2020
Topics: Program Administration