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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 5741 - 5750 of 15689

Tennessee
This SPA allows the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act.
Approval Date: March 13, 2020
Effective Date: October 1, 2019
Topics: Program Administration

Indiana
This SPA make Changes to Pharmacy DUR language to adhere to SUPPORT Act requirements
Approval Date: March 13, 2020
Effective Date: November 28, 2019
Topics: Current State Plan Prescription Drugs Program Administration

South Carolina
Incorporates the language mandated in 1902 (a)(85) and Section 1004 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act
Approval Date: March 13, 2020
Effective Date: October 1, 2019
Topics: Prescription Drugs Program Administration

Nevada

Updates Services for Individuals Age 65 or Older in IMDs and Inpatient Psychiatric Facility Services for Individuals Under 22 Years of Age in order to align certain timeframes related to prior authorization.

Approval Date: March 13, 2020
Effective Date: February 1, 2020
Topics: Benefits Eligibility Health Services Initiatives

Arizona
The proposed amendment updates emergency transportation rates
Approval Date: March 12, 2020
Effective Date: October 1, 2019
Topics: Financing & Reimbursement

Arizona
Updates the reimbursement methodology for outpatient differential adjusted payments
Approval Date: March 12, 2020
Effective Date: October 1, 2019
Topics: Financing & Reimbursement

Oklahoma
Removes copays for medication assisted treatment (MAT) drugs for opioid use
Approval Date: March 11, 2020
Effective Date: January 1, 2020
Topics: Individual CoPayments or Insurance Payments Prescribed Drugs

Oregon
revise the Behavioral Health rehabilitation and include a level of care for Intensive In-Home Behavioral Health Services as a part of Oregon’s services for children’s behavioral health.
Approval Date: March 11, 2020
Effective Date: July 1, 2020

Maine
Updates the outpatient hospital supplemental pool reimbursement description
Approval Date: March 11, 2020
Effective Date: November 14, 2019
Topics: Financing & Reimbursement

Michigan

Changes to the state's Pharmacy DUR language in compliance with the SUPPORT Act.

Approval Date: March 11, 2020
Effective Date: October 1, 2019
Topics: Current State Plan Prescription Drugs Program Administration