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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 4351 - 4360 of 15911

New Jersey

This amendment continues reimbursement authority for New Jersey's Charity Care Subsidy Disproportionate Share Hospital (DSH) program in the amount of $319,000,000.

Approval Date: November 23, 2021
Effective Date: July 1, 2021

Virginia

This plan amendment provides reimbursement for vaccines administered by pharmacies (pharmacists, pharmacy interns, or pharmacy technicians).

Approval Date: November 23, 2021
Effective Date: October 1, 2021
Topics: Reimbursement Vaccine - Reimbursement

Montana

This amendment updates the reimbursement methodology for nursing facility services for State Fiscal Year 2022.

Approval Date: November 23, 2021
Effective Date: July 1, 2021

South Dakota

This SPA implements inflationary rate and targeted rate increases appropriated by the state legislature during the 2021 legislative session, increases the pharmacy dispensing fee, clarifies out-of-state inpatient hospital reimbursement, and clarifies DRG grouper 522 coverage.

Approval Date: November 23, 2021
Effective Date: July 1, 2025

Idaho
This amendment revises the reimbursement methodology for Acute Care Hospitals. 
Approval Date: November 22, 2021
Effective Date: July 1, 2021

Iowa
This SPA changes the total funding of the Iowa State-Owned Hospital payment to $0.00 resulting from the implementation of the managed care state-directed payment to the Iowa State-Owned Hospital.
Approval Date: November 22, 2021
Effective Date: July 1, 2021

Pennsylvania
This amendment establishes the annual aggregate limit and continues funding for inpatient disproportionate share, outpatient supplemental and direct medical education payments.
Approval Date: November 22, 2021
Effective Date: September 5, 2021

California

This SPA updates the eligibility requirements for the Health Insurance Premium Payment (HIPP) program by removing the requirement that if a HIPP beneficiary has an option to enroll in a Medi-Cal managed care plan then they are ineligible for HIPP.

Approval Date: November 22, 2021
Effective Date: July 1, 2021

Montana
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to temporarily increase payment rates for state plan home and community-based services through quarterly supplemental payments based upon a percentage of Medicaid allowable paid claims in order to maintain a stable workforce and preserve services during the declared public health emergency.
Approval Date: November 19, 2021
Effective Date: April 1, 2021
Topics: Disaster Relief Financing & Reimbursement

New York
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to increase the current COVID-19 Vaccine Administration Fee from $13.23 per dose to $40.00 per dose to all qualified Medicaid enrolled health care providers except when it is a Federally Qualified Health Center or Rural Health Center encounter.
Approval Date: November 19, 2021
Effective Date: April 1, 2021
Topics: Disaster Relief Financing & Reimbursement Vaccine