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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 4671 - 4680 of 15693

Mississippi
Effective January 1, 2021, this amendment allows the Division of Medicaid (DOM) to remove the list of specific Current Dental Terminology (CDT) codes.
Approval Date: May 24, 2021
Effective Date: January 1, 2021
Topics: Benefits Current State Plan Program Administration

Connecticut
Effective January 1, 2021, this amendment incorporates various 2021 Healthcare Common Procedure Coding System (HCPCS) updates, updated the reimbursement methodology to 100% of the January 2021 Medicare Average Sales Price (ASP) Drug Pricing file for physician-administered drugs, immune globulins, vaccines and toxoids and made technical updates to the Person-Centered Medical Home (PCMH) program.
Approval Date: May 24, 2021
Effective Date: January 1, 2021
Topics: Current State Plan Financing & Reimbursement

Ohio
Effective January 1, 2021, this amendment updates the Non-Institutional Payment Schedules for 2021. 
Approval Date: May 24, 2021
Effective Date: January 1, 2021
Topics: Financing & Reimbursement

Pennsylvania
This amendment will continue certain benefits changes beyond the end of the COVID-19 Public Health Emergency (PHE).  The home health, prescription drug, targeted case management, and nursing facility benefits in this SPA was originally approved on May 24, 2021.  At the time of approval, the end date of the PHE was not known.  Now that the date is known, this SPA has been updated to reflect an effective date of May 12, 2023.
Approval Date: May 24, 2021
Effective Date: May 12, 2023

Rhode Island
Home Care Rate Increases and Enhancements
Approval Date: May 23, 2021
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

Maryland
Creates a Family Planning Presumptive Eligibility (FPE) Program to enroll participants in a temporary eligibility group to receive family planning services. Participants enroll at Family Planning Qualified Entities (FPEQEs), which are Maryland Family Planning Program Delegate Service Sites enrolled in Medicaid that are in good standing. The goal of FPE is to provide a pathway to longer-term Family Planning Program coverage by allowing participants to have timely access to family planning health care services through an on-site, temporary eligibility determination.
Approval Date: May 21, 2021
Effective Date: January 1, 2021
Topics: Benefits Program Administration

Colorado
Effective July 30, 2021, this amendment revises the frequency of the state's cost of dispensing survey from specifying that it will occur every two years to noting that it will occur periodically.
Approval Date: May 21, 2021
Effective Date: June 30, 2021
Topics: Financing & Reimbursement

New Hampshire

This SPA provide for an increase in teh Standards for the Optional State Supplementary Programs.

Approval Date: May 21, 2021
Effective Date: January 1, 2021

Wisconsin
Modifies the income limits for the Optional State Supplement Beneficiaries to reflect the Social Security Cost of living Adjustment (COLA)
Approval Date: May 20, 2021
Effective Date: January 1, 2021
Topics: Program Administration

Hawaii
Effective January 1, 2021, this amendment removes the limits on smoking cessation counseling and pharmacotherapy services. 
Approval Date: May 20, 2021
Effective Date: January 1, 2021