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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 5221 - 5230 of 15690

Maryland
Expands the categories of providers allowed to order home health services to include nurse practitioners, and additionally revises the SPA language to reflect compliance with updated HH regulations and EVV requirements. 
Approval Date: September 23, 2020
Effective Date: July 25, 2020
Topics: Health Homes Program Administration

Indiana
Adds additional service units using the prior authorization (PA) process per the Mental Health Parity and Addiction Equity Act (MHPAEA)
Approval Date: September 23, 2020
Effective Date: October 1, 2020

Illinois
adjust the long-term care regional wage adjustor.
Approval Date: September 23, 2020
Effective Date: June 1, 2020
Topics: Program Administration

Colorado
Updates and corrects the assurances selected related to utilization review to indicate that the Department undertakes utilization review requirements through a contract with a utilization and Quality Improvement Organization (QIO) or QIO-Like Entity.
Approval Date: September 23, 2020
Effective Date: April 1, 2020
Topics: Program Administration

Massachusetts
Updates the Methods Used to Determine Rates of Payment for Acute Outpatient Hospital Services to Bill for Nasal Naloxone
Approval Date: September 22, 2020
Effective Date: April 1, 2020
Topics: Financing & Reimbursement Program Administration

Maine
Increase reimbursement rates for certain psychiatric medication management services and home and community-based behavioral therapy service rates
Approval Date: September 22, 2020
Effective Date: April 1, 2020
Topics: Financing & Reimbursement

Maine
Updates the reimbursement methodologies for Multisystemic Therapy (MST), Multisystemic Therapy for Problem Sexualized Behaviors (MST-PSB), and
Functional Family Therapy (FFT) in order to reflect requirements for the evidence-based models, and to change the unit of service from a quarter-hour to a week.
Approval Date: September 22, 2020
Effective Date: June 30, 2020
Topics: Financing & Reimbursement Program Administration

Arkansas
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to modify the other licensed practitioner benefit to allow licensed pharmacists within their state scope of practice with CLIA waiver certification to provide diagnostic COVID-19 antigen tests; and to reimburse pharmacists providing COVID testing using a state-developed fee schedule for diagnostic testing.
Approval Date: September 22, 2020
Effective Date: June 25, 2020
Topics: Benefits Disaster Relief Financing & Reimbursement

Maine
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to include additional coverage and payment for COVID-19 testing, add teledentistry to telehealth benefits, add publicly-owned hospitals to those eligible to receive supplemental payments, and to add qualifications for direct support professionals, mental health rehabilitation technicians and behavioral health professionals.
Approval Date: September 22, 2020
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief Financing & Reimbursement

Maine
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to rescind the payment increases in Section 7.4, E.2.b.ii of the state plan.
Approval Date: September 22, 2020
Effective Date: June 1, 2020
Topics: Disaster Relief Financing & Reimbursement