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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 4861 - 4870 of 15692

New Mexico
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 pharmacists, pharmacy interns, pharmacy technicians, and pharmacies as qualified providers of COVID-19 vaccinations and to implement reimbursement for the COVID-19 vaccine administration.
Approval Date: March 19, 2021
Effective Date: December 1, 2020
Topics: Disaster Relief Financing & Reimbursement

Louisiana
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to cover pharmacy technicians, pharmacy interns and pharmacies under the Other Licensed Practitioner (OLP) benefit to administer COVID 19 vaccinations and reimburse administration of COVID-19 vaccines and treatments at 100 percent of Louisiana Region 99 Medicare rates.
Approval Date: March 19, 2021
Effective Date: November 2, 2020
Topics: Disaster Relief Financing & Reimbursement

Massachusetts
Effective 10/01/2020, this amendment updates the methods and standards used to revise the payment rates for acute outpatient psychiatric and substance abuse outpatient hospitals. 
Approval Date: March 19, 2021
Effective Date: October 1, 2020
Topics: Financing & Reimbursement

Maine
Effective January 01, 2021, this amendment updates the income standards for recipients of Maine's Optional State Supplement Payments. 
Approval Date: March 19, 2021
Effective Date: January 2, 2021
Topics: Eligibility Financing & Reimbursement Program Administration

New Jersey
Implements the state’s change from using the Federally Facilitated Marketplace (FFM) to take applications and determine MAGI-based Medicaid eligibility to instead use a State Based Marketplace (SBM) to make those same eligibility determinations. The SBM will be operational for plan year 2021.
Approval Date: March 19, 2021
Effective Date: November 1, 2020

Maine
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to Implement an add-on payment to primary care, behavioral health and dental service providers, increase reimbursement for private non-medical institutions by at least 17.2%, allow nursing facilities to relocate individuals with acquired brain injuries to a quarantine unit when diagnosed with COVID-19, allow facilities to relocate residential care patients to a nursing facility bed or nursing facility patients to a residential care bed due to COVID-19, allow pharmacies to bill for COVID-19 testing, and allow physician assistants, nurse practitioners and clinical nurse specialists to be considered qualified providers for ordering and recertifying a plan of care for private duty nursing services.
Approval Date: March 18, 2021
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief Reimbursement

Ohio
Effective 12/31/2020, this amendment updates reimbursement methodology for nursing facility services - case mix scores and ventilator services.
Approval Date: March 18, 2021
Effective Date: December 31, 2020
Topics: Financing & Reimbursement

Pennsylvania
Effective December 27, 2020, this amendment continues an additional class of disproportionate share hospital payment to facilities meeting certain low-Income utilization rate (LIUR) and net patient revenue criteria while operating in a medically underserved area.
Approval Date: March 17, 2021
Effective Date: December 27, 2020
Topics: Financing & Reimbursement Program Administration

Connecticut
This plan amendment updates the home health services fee schedule.
Approval Date: March 17, 2021
Effective Date: November 1, 2020
Topics: Financing & Reimbursement

Connecticut
This amendment increases the rate for Healthcare Common Procedure Coding System code J7307- Etonogestrel implant system on the physician office and outpatient fee schedule. 
Approval Date: March 17, 2021
Effective Date: December 1, 2020
Topics: Financing & Reimbursement