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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 5111 - 5120 of 15690

Louisiana
The purpose of this SPA is to amend the provisions governing reimbursement for end stage renal disease (ESRD) facilities in order to allow contracted independent laboratories to bill the Medicaid program directly for the provision of covered non-routine laboratory services instead of receiving reimbursement from the ESRD facility
Approval Date: November 9, 2020
Effective Date: October 20, 2020
Topics: Financing & Reimbursement

Mississippi
This plan amendment was submitted to increase the fee schedule rate to 100% of the Medicare urban ambulance fee schedule for emergency ground transportation services as well as add a mileage component for emergency transportation services. 
Approval Date: November 9, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

Texas
This state plan amendment updates the durable medical equipment, prosthetics, orthotics, supplies (DMEPOS) and vision care services fee schedules.
Approval Date: November 9, 2020
Effective Date: September 1, 2020

Texas
updates the durable medical equipment, prosthetics, orthotics, supplies (DMEPOS) and vision care services fee schedules
Approval Date: November 9, 2020
Effective Date: September 1, 2020
Topics: Program Administration

Idaho
modifies the methodology in which nursing facilities (NFs) receive supplemental payment through their NF upper payment limit (UPL) supplemental payment program. 
Approval Date: November 9, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

North Carolina
proposes to change methodologies for calculating the inpatient UPL.  The state will change from a DRG methodology to a per diem methodology
Approval Date: November 9, 2020
Effective Date: February 1, 2020
Topics: Financing & Reimbursement Program Administration

North Carolina
 This SPA modifies Attachment 4.19-A of North Carolina’s Title XIX State Plan.  Specifically this amendment proposes to modify the language describing reimbursement to NC state border hospitals in need of inpatient services.   
Approval Date: November 9, 2020
Effective Date: February 1, 2020
Topics: Financing & Reimbursement

Indiana
makes changes to implement an end of therapy reclassification methodology in the RUG IV, 48-Group model for payment of nursing facilities
Approval Date: November 9, 2020
Effective Date: July 1, 2020
Topics: Program Administration

Arkansas
amendments to include new therapy Current Procedural Terminology (CPT) evaluation codes
Approval Date: November 9, 2020
Effective Date: January 1, 2021
Topics: New Labeler Codes Program Administration

California

This SPA updates the third-party liability section of the state plan to use standard coordination of benefits cost avoidance when processing claims for prenatal services.

Approval Date: November 6, 2020
Effective Date: October 1, 2020