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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 4831 - 4840 of 15692

Pennsylvania
update the Program of All-Inclusive Care for the Elderly (PACE) Medicaid capitation rate methodology. This SPA transitions from using Fee-for-Service
(FFS) data to using Managed Care for development of the amount that would otherwise have been paid (AWOP) calculation.
Approval Date: March 30, 2021
Effective Date: July 1, 2021

North Carolina
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this COVID - 19 Medicaid Disaster Relief Round 7 State plan amendment is to allow pharmacists to administer vaccines for COVID-19.
Approval Date: March 29, 2021
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief

Massachusetts
This plan amendment updates the methods and standards to set payment rates for acute outpatient hospitals.
Approval Date: March 29, 2021
Effective Date: October 1, 2020
Topics: Financing & Reimbursement

California
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to increase the reimbursement of oxygen, oxygen equipment and respiratory equipment to 100% of the corresponding Medicare rates and exempt these rates from the 10 percent payment reductions authorized in the state plan.
Approval Date: March 26, 2021
Effective Date: March 1, 2021
Topics: Disaster Relief Financing & Reimbursement

Massachusetts
This is an amendment to rates for nursing facilities and establishes additional payment methodologies associated with COVID-19 supports and oversights for fiscal year 2021.
Approval Date: March 26, 2021
Effective Date: October 1, 2020
Topics: Financing & Reimbursement

Illinois
Effective October 1, 2019, this amendment 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 26, 2021
Effective Date: October 1, 2019
Topics: Prescription Drugs Program Administration

Nevada
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to update the Other Licensed Practitioners to include pharmacies, pharmacy interns, qualified pharmacy technicians, and licensed dental hygienists, and to allow for 100% Medicare payment for COVID-19 vaccine administration.
Approval Date: March 25, 2021
Effective Date: December 11, 2020
Topics: Benefits Disaster Relief Reimbursement

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 temporary rate increases for adult day health and day habilitation providers during the public health emergency. The Commonwealth proposes to change the unit rate from a 15 minute increment rate, to full day and partial day per diem rates.
Approval Date: March 25, 2021
Effective Date: August 1, 2020
Topics: Disaster Relief Reimbursement

Arizona
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to permit a second COVID-19 related direct payment for nursing facilities that is identical to the first approved payment. The payment for each provider is computed at $30 multiplied by the number of Medicaid fee-for-service bed days during the proxy period of 10/1/19 to 12/31/19.
Approval Date: March 25, 2021
Effective Date: January 1, 2021
Topics: Disaster Relief Reimbursement

Texas
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to allow licensed practitioners practicing within their scope of practice, such as nurse practitioners and physician assistants, to order Medicaid home health services during the COVID-19 pandemic.
Approval Date: March 25, 2021
Effective Date: March 18, 2021
Topics: Benefits Disaster Relief