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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 5751 - 5760 of 15690

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

Louisiana
amends provisions governing the Pharmacy Benefits Management program in order to allow the state to pursue out-comes based agreements with manufacturers and to align the provisions with the current Medicaid State plan.
Approval Date: March 11, 2020
Effective Date: March 11, 2020
Topics: Benefits Pharmacy Benefit Managers (PBMs)

New Jersey
Family Planning and Family Planning Related Services
Approval Date: March 10, 2020
Effective Date: October 1, 2019
Topics: Current State Plan Program Administration

New Jersey
Adds coverage for Long-Term Residential Substance Use Disorder Services to the Title XIX and State Plan 
Approval Date: March 10, 2020
Effective Date: October 1, 2018

Nevada
Consolidates the supervision of the Peer Supporter under the Clinical Supervisor with the Behavioral Health Community Network (BHCN) and removes the requirement of medical supervision for the provider
Approval Date: March 10, 2020
Effective Date: January 1, 2020
Topics: Current State Plan Program Administration

Ohio
Proposes changes to coverage and limitations for dental services to reflect changes in the practice of dentistry, and updates payment rates
Approval Date: March 10, 2020
Effective Date: January 1, 2020
Topics: Benefits Eligibility Financing & Reimbursement

North Carolina

Revises North Carolina’s End State Renal Disease (ESRD) program’s policies and titles to expand dialysis to patients diagnosed with Acute Kidney Injuries (AKI).

Approval Date: March 10, 2020
Effective Date: January 1, 2020

Georgia
Proposes to allow 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)
Approval Date: March 10, 2020
Effective Date: January 1, 2020
Topics: Current State Plan Prescription Drugs Program Administration

Nebraska
This SPA describes the methodology used by the state for determining the appropriate FMAP rates, including the increased FMAP rates, available under the provisions of the Affordable Care Act applicable for the medical assistance expenditures under the Medicaid program associated with enrollees in the new adult group adopted by the state and described in 42 CFR 435.119.
Approval Date: March 10, 2020
Effective Date: October 1, 2020

Nebraska
This SPA adds coverage for the eligibility group for adults with income below 133% of the FPL under Section 1902(a)(10)(A)(viii) of the Social Security Act
Approval Date: March 10, 2020
Effective Date: October 1, 2020
Topics: Current State Plan Eligibility Program Administration