U.S. flag

An official website of the United States government

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 4941 - 4950 of 15690

Louisiana
The Louisiana Department of Health, Bureau of Health Services Financing proposes to amend the provisions governing the reimbursement methodology for nursing facilities in order to increase the allowable square footage for calculating payments when a Medicaid participating nursing facility has at least 15 percent of its licensed beds in private rooms
Approval Date: February 17, 2021
Effective Date: December 20, 2020
Topics: Financing & Reimbursement

Alaska
Updates the plan to expand coverage and reimbursement for vaccine administration in accordance with authorizations provided under the Public Readiness and Emergency Preparedness (PREP) Act declaration.    Further, it clarifies the reimbursement methodology for medically necessary vaccines products; expands the list of practitioners able to order Home Health services; clarifies the administrative vaccine rate for children eligible under the Vaccine for Children (VFC) Program; and, incorporates reimbursement for administration of vaccinations to the adult population.  
Approval Date: February 17, 2021
Effective Date: October 1, 2020
Topics: Financing & Reimbursement Vaccine - Policy Clarification

Minnesota
This SPA revises state plan language to modify the requirements for delivery of case management services
Approval Date: February 12, 2021
Effective Date: October 1, 2021

Massachusetts
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purposes of this amendment is to update Payment Methodologies for Certain Hospital, Community Health Centers, Physician, and coverage for mobile testing service done by EMTs during the COVID-19 Emergency period.
Approval Date: February 12, 2021
Effective Date: March 1, 2020
Topics: Coverage Disaster Relief Financing & Reimbursement

Iowa
Proposes to allow Physician Assistants to bill independently from the supervising physician. The SPA also establishes a rate payment for Physicians Assistants
Approval Date: February 11, 2021
Effective Date: December 1, 2020
Topics: Financing & Reimbursement

Washington
Implements a resource disregard of earnings accumulated in a separate account during an individual's enrollment in a working disability eligibility group when determining the individual's subsequent eligibility for other eligibility groups covered under Washington’s state plan
Approval Date: February 10, 2021
Effective Date: April 1, 2020

Oklahoma
Requires the use of an Electronic Visit Verification (EVV) system for personal care services (PCS) that require and in-home visit
by a provider.
Approval Date: February 4, 2021
Effective Date: January 1, 2021
Topics: Program Administration

Indiana
Care Coordination Services for Mental Health and Substance Use Disorders
Approval Date: February 4, 2021
Effective Date: January 1, 2021
Topics: Benefits Program Administration

Pennsylvania
Effective January 24, 2021, this amendment continues Pennsylvania's authority to continue Medical Assistance Day One Incentive (MDOI) payments to nonpublic nursing facilities and sets the funding levels for Fiscal Year 2021.
Approval Date: January 24, 2021
Effective Date: January 24, 2021
Topics: Benefits Financing & Reimbursement

Missouri

Effective December 16, 2018, this amendment brings Missouri into compliance with items contained in the reimbursement requirements for the Covered Outpatient Drug final rule with comment period (CMS-2345-FC) and includes: reimbursement rates for long-term care, specialty drugs, drugs purchased at a nominal price, and physician administered drugs and reimbursement methods that use, among others, the National Average Drug Acquisition Cost (NADAC) for covered outpatient drugs.

Approval Date: January 19, 2021
Effective Date: December 16, 2018
Topics: Financing & Reimbursement