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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 2651 - 2660 of 15708

Pennsylvania
Proposes to amend the pharmacy pages provisions to cover select non-legend drug products.
Approval Date: March 1, 2023
Effective Date: January 1, 2023

Indiana
This amendment updates the alternative benefit plan to include coverage requirements for routine patient costs associated with participation in clinical trials and extends the prescription drug supply limit from thirty (30) days to ninety (90) days for the Health Indiana Plan (HIP) Basic group.
Approval Date: March 1, 2023
Effective Date: October 1, 2022
Topics: Alternative Benefit Plan

Michigan
Provides authority for coverage and payment of targeted case management for individuals age 18 and older who meet Medicaid eligibility requirements, have a chronic or complex physical or behavioral health need, and were recently incarcerated.
Approval Date: March 1, 2023
Effective Date: April 1, 2023

Kansas
Long acting reversible contraceptive (LARC) devices are no longer included in the Diagnosis Related Group (DRG) rates. LARC devices will be reimbursed on a fee-for-service basis.
Approval Date: March 1, 2023
Effective Date: January 1, 2023

Wisconsin
Effective for services on or after October 1, 2022, this amendment modifies the timeline of the Hospital Withhold Pay-for-Performance (HWP4P) program payments in the State Plan. HWP4P payments are made by the end of the
calendar year following the HWP4P measurement year.
Approval Date: March 1, 2023
Effective Date: October 1, 2022

New Hampshire
Effective October 1, 2022, this amendment revises the quarterly nursing home supplemental payment, also known as MQIP, for dates of service in the quarter ending December 31, 2022.
Approval Date: March 1, 2023
Effective Date: October 1, 2022

Missouri
This State Plan Amendment updates the inpatient hospital reimbursement methodology, and deletes or clarifies outdated language.
Approval Date: March 1, 2023
Effective Date: July 1, 2022

Pennsylvania
This amendment proposes to continue to make supplementation payments to qualifying nonpublic nursing facilities.
Approval Date: March 1, 2023
Effective Date: January 1, 2023

Pennsylvania
This amendment proposes to continue to make additional payments to nonpublic and county nursing facilities that qualify for supplemental ventilator care and tracheostomy care.
Approval Date: March 1, 2023
Effective Date: January 1, 2023

Pennsylvania
This amendment proposes to continue funding for multiple classes of inpatient DSH payments and supplemental payments to Medical Assistance enrolled, qualifying inpatient acute care general hospitals.
Approval Date: March 1, 2023
Effective Date: December 25, 2022