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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 4721 - 4730 of 15693

Ohio
Effective May 1, 2021, this amendment provides approval for Third Party Liability (TPL): Blanket good cause exception for children in state custody; 100-day timeline for billing non-responsive third parties. 
Approval Date: May 10, 2021
Effective Date: May 1, 2021
Topics: Financing & Reimbursement

New Mexico
Effective March 1, 2021, this amendment implements a new reimbursement methodology for all Indian Health Services and Tribal 638 pharmacy facilities based on the All-Inclusive Rate (AIR). 
Approval Date: May 10, 2021
Effective Date: March 1, 2021

Hawaii
creates a new eligibility group. This group, also identified under the “Ticket to Work and Work Incentives Improvement Act” authority, allows individuals with a disability at least 19 years of age but less than 65 years of age whose income is below 138% of the Federal Poverty Level and applicable Household size a resource standard equal to three (3) times the SSI resource limit adjusted annually by the increase in the consumer price index to qualify and or keep their Medicaid coverage.
Approval Date: May 10, 2021
Effective Date: January 1, 2021

Rhode Island
Increases the Home Equity Limit for Long-Term Care.
Approval Date: May 10, 2021
Effective Date: January 1, 2021
Topics: Program Administration

District of Columbia
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to provide Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) with a direct support professional (DSP) supplemental payment for the January 1, 2021 to March 31, 2021 period.
Approval Date: May 7, 2021
Effective Date: January 1, 2021
Topics: Disaster Relief Reimbursement

Hawaii
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to increase the payment rates for the administration of COVID-19 vaccines to the Medicare rate.
Approval Date: May 7, 2021
Effective Date: January 15, 2021
Topics: Disaster Relief Reimbursement

Michigan
This SPA provides authority to modify additional payments for specific COVID-19 nursing facilities. Effective January 1, 2021, the agency rescinds the election at Section E.2. of Payments of section 7.4 (approved on 06/05/2020 in SPA Number MI-20-0005) of the state plan to provide supplemental payments for Nursing Facility COVID-19 Regional Hub as designated by the State of Michigan.
Approval Date: May 7, 2021
Effective Date: January 1, 2021
Topics: Disaster Relief Reimbursement

Ohio
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to add coverage and payment provisions for the administration of COVID-19 vaccinations and establishes all pharmacy professionals (pharmacists, techs, and interns) as qualified providers of the vaccine.
Approval Date: May 7, 2021
Effective Date: December 11, 2020
Topics: Benefits Disaster Relief Reimbursement

Oregon
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to add on a rate for Non Emergent Medical Transportation (NEMT) providers, to compensate for their wait times at drive through vaccination sites. The anticipated impact to beneficiaries for this SPA is neutral.
Approval Date: May 7, 2021
Effective Date: January 1, 2021
Topics: Disaster Relief Reimbursement

West Virginia
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. This state plan amendment provides coverage of the administration of COVID-19 vaccines upon Emergency Use Authorization or approval from the Food and Drug Administration. This state plan amendment also increases reimbursement for COVID-19 vaccine administration based on the Medicare prevailing rate.
Approval Date: May 7, 2021
Effective Date: December 1, 2020
Topics: Benefits Disaster Relief Reimbursement