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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 4761 - 4770 of 15693

New York
Effective January 1, 2017, this amendment revises reimbursement for inpatient hospital services. Specifically, it provides additional payments to specialty, critical access and physical medical rehabilitation hospitals to account for increases in the minimum wage (MW). 
Approval Date: April 28, 2021
Effective Date: January 1, 2017

Illinois
Effective January 1, 2021, this amendment provides a reimbursement methodology for hospital rates that defines rate year. 
Approval Date: April 28, 2021
Effective Date: January 1, 2021
Topics: Financing & Reimbursement

South Dakota
Effective March 1, 2020, this amendment establishes coverage of COVID-19 vaccine administration and a reimbursement rate for COVID-19 vaccine administration for providers reimbursed on a fee-for-service basis. 
Approval Date: April 28, 2021
Effective Date: March 1, 2020
Topics: Disaster Relief Program Administration Tribal Issues

Massachusetts
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 additional payment methodologies for home health and private duty nursing services.
Approval Date: April 27, 2021
Effective Date: June 1, 2020
Topics: Disaster Relief Reimbursement

Ohio
Effective August 1, 2021 and expiring on July 31, 2026, this amendment renews Ohio's 1915(i) State Plan Home and Community Based Services (HCBS) benefit, specialized recovery services program.
Approval Date: April 27, 2021
Effective Date: August 1, 2021
Topics: Benefits Current State Plan

Montana
Effective April 1, 2021, this amendment approves the continuation of the exception to the recovery audit contractor (RAC) requirements through April 30, 2023.
Approval Date: April 27, 2021
Effective Date: April 1, 2021
Topics: Financing & Reimbursement Program Administration Program Integrity

South Dakota
Effective January 01, 2021, this amendment allows substance use disorder (SUD) agencies to be reimbursed an originating site fee for acting as a telemedicine originating site. 
Approval Date: April 26, 2021
Effective Date: January 1, 2021
Topics: Current State Plan Financing & Reimbursement

Pennsylvania
Effective April 1, 2020, this amendment proposes to provide Medicaid coverage of durable medical equipment to support beneficiaries' mobility-related activities of daily living. 
Approval Date: April 26, 2021
Effective Date: April 1, 2020

Maine
Effective August 19, 2020 this amendment adds coverage and reimbursement for three evidence-based parenting programs for children with disruptive behavior disorders. 
Approval Date: April 22, 2021
Effective Date: August 19, 2020
Topics: Benefits Coverage Reimbursement

Texas
Updates the birthing center facility services fee schedule
Approval Date: April 21, 2021
Effective Date: March 1, 2021
Topics: Financing & Reimbursement