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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 5621 - 5630 of 15690

Pennsylvania
Continues an additional class of disproportionate share hospital payment to qualifying hospitals
that provide medical and surgical services for ocular disease and injuries
Approval Date: April 24, 2020
Effective Date: March 8, 2020
Topics: Financing & Reimbursement Program Administration

Oregon
This SPA adds Lactation Consultant Services as a billable provider type
Approval Date: April 24, 2020
Effective Date: April 1, 2020

California
Adjusts the Medi-Cal Fee-for-Service (FFS) reimbursement rates for Durable Medical Equipment (DME) services using the Medicare rural fee schedule for DME, Prosthetics, Orthotics, and Supplies
Approval Date: April 23, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

New Hampshire
Updates the allowance for a 3.1% increase to Home and Community Based Care for High Risk Children with Severe Emotional Disturbance rates
Approval Date: April 23, 2020
Effective Date: January 1, 2020
Topics: Benefits Financing & Reimbursement Program Administration

California
requests a two-year extension of the previously approved exception to renew the Recovery Audit Contractor (RAC)
Approval Date: April 23, 2020
Effective Date: February 1, 2020

New Mexico
increases the payment rates for Long-Acting Reversible Contraception (LARC) administration and insertion codes effective January 1, 2020
Approval Date: April 23, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Arkansas
Establishes new provider qualification requirements for targeted case managers in ARChoices Personal Care.
Approval Date: April 23, 2020
Effective Date: July 1, 2020
Topics: Current State Plan Program Administration

California
Adds Orange County (Group 4) to the existing Health Home Program with the population criterion of Serious Mental Illness (SMI) or Serious Emotional Disturbance (SED)
Approval Date: April 22, 2020
Effective Date: July 1, 2020

Louisiana

This SPA amends the provisions governing school-based medical services covered in the Early and Periodic Screening, Diagnosis and Treatment Program and school-based behavioral health services in order to: (1) add services categorized as 504 plans, individual health plans or otherwise medically necessary in addition to those covered by an individual education plan, to the services available for school-based Medicaid claiming; (2) amend the reimbursement methodology to expand allowable billing providers for direct/therapy and nursing services; and (3) add applied behavioral analysis, personal care services and transportation to allowable Medical billing.

Approval Date: April 21, 2020
Effective Date: March 20, 2019
Topics: Program Administration

Puerto Rico
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing, impose less restrictive resource tests on certain eligibility groups, and to continue to consider residents who leave the Territory due to the disaster residents of the Territory.
Approval Date: April 21, 2020
Effective Date: March 1, 2020
Topics: Disaster Relief Eligibility