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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 5231 - 5240 of 15690

Colorado
updates drug reimbursement for outpatient hospital services
Approval Date: September 22, 2020
Effective Date: June 1, 2020
Topics: Financing & Reimbursement

Maine
Designates entities that furnish health care items and services covered under the state plan as qualified entities to make presumptive eligibility determinations for the family planning group
Approval Date: September 22, 2020
Effective Date: October 1, 2020
Topics: Current State Plan Eligibility

Kansas
This amendment adds "unit” to “transfer” definition and “wing” is changed to “unit” in section 2.5400.
Approval Date: September 20, 2020
Effective Date: July 1, 2020

Indiana
Changes the Medicaid State Plan with technical changes to remove diagnosis related group (DRG) version and numbering to clarify information on the state's website.
Approval Date: September 20, 2020
Effective Date: August 1, 2020
Topics: Program Administration

New Jersey
Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Autism Benefit to include Autism Spectrum Disorder (ASD)
Approval Date: September 18, 2020
Effective Date: January 1, 2019
Topics: Benefits Program Administration

North Carolina
increases the Evaluation and Management codes for primary care physicians and physician assistants by 1%
Approval Date: September 18, 2020
Effective Date: April 1, 2020
Topics: Financing & Reimbursement

Northern Mariana Islands
Updates the dental fee schedule language
Approval Date: September 18, 2020
Effective Date: October 1, 2020

Washington
Directs the Health Care Authority to increase psychiatric per diem rates for community hospitals that serve patients in long-term commitments of 90 days or longer.
Approval Date: September 18, 2020
Effective Date: July 1, 2020
Topics: Program Administration

Colorado
Updates the methodology for existing, supplemental payments for nursing facilities (NFs)
Approval Date: September 18, 2020
Effective Date: July 1, 2020
Topics: Allocation Methodologies Program Administration

California
Updates All Patient Refined Diagnosis Related Group (APR-DRG) payment parameters for state fiscal year 2020-2021.
Approval Date: September 18, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement