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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 5761 - 5770 of 15689

Massachusetts
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 (P.L. 115-271).
Approval Date: March 10, 2020
Effective Date: October 1, 2019

South Dakota
Clarifies that census bureau wages for temporary employment Goals and Objectives related to decennial census activities are not considered countable income.
Approval Date: March 10, 2020
Effective Date: January 13, 2020
Topics: Financing & Reimbursement Program Administration

Ohio
This SPA proposes increases to the Medicaid maximum payment amounts for transportation services in accordance with recent state legislation
Approval Date: March 9, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Illinois
Proposes a $60 increase to the LTAC base per diem rate
Approval Date: March 9, 2020
Effective Date: January 1, 2020

Connecticut
Proposes to update the payment rates for nursing facility residents to provide for reimbursement when a resident of a Disaster Struck Nursing Facility must be temporarily evacuated to another facility due to a disaster for a period of up to thirty (30) days.
Approval Date: March 9, 2020
Effective Date: November 1, 2019
Topics: Financing & Reimbursement

Alabama
Proposes to apply the reimbursement methodology for inpatient and outpatient hospital services for State fiscal year 2020 in a manner consistent with that used in fiscal year 2019
Approval Date: March 9, 2020
Effective Date: October 1, 2019
Topics: Financing & Reimbursement

Michigan
Clarifies coverage of certain Active Pharmaceutical Ingredients (APIs) and Excipients when billed as part of a compounded drug claim
Approval Date: March 6, 2020
Effective Date: October 1, 2019
Topics: Benefits Eligibility Prescription Drugs

Washington
Affirms state compliance with sections 1902(a)(85), 1902(a)(83)(oo), and 1927(g) of the Social Security Act; updates Drug Utilization Review program information; affirms state fraud and abuse processes related to opioids; affirms MCO requirements to participate in SUPPORT Act-mandated actions; and updates language to align with language in the Social Security Act and CFR
Approval Date: March 6, 2020
Effective Date: October 1, 2019

Maine
Proposes reimbursement to hospitals other than critical access hospitals for each day after the tenth (10th) day that an eligible individual is in the care of the hospital while awaiting placement in a nursing facility
Approval Date: March 6, 2020
Effective Date: October 1, 2019
Topics: Eligibility Financing & Reimbursement

Wisconsin
Updates WI's drug utilization program provisions to include requirements established in the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act
Approval Date: March 5, 2020
Effective Date: October 1, 2019