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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 6151 - 6160 of 15886

Illinois
Increases Rates for Behavioral Health Services
Approval Date: December 20, 2019
Effective Date: July 1, 2019

California
This State Plan Amendment is required to implement state Senate Bill (SB) 104 (2019). SB 104 increases the Blind Federal Poverty Level (FPL) and the Aged and Disabled FPL program income limits by increasing the income disregard to all countable income above the SSI/SSP payment standard up to 138% of FPL for the Blind FPL program and 100% up to 138% FPL for the Aged and Disabled FPL program. The income disregard is applied after all other exclusions and disregards.
Approval Date: December 20, 2019
Effective Date: August 1, 2020
Topics: Eligibility Program Administration

Oklahoma
Proposes to increase the nursing facility pool amounts, base rate components for nursing facilities serving adults and AIDS patients.
Approval Date: December 19, 2019
Effective Date: July 1, 2019

Oklahoma
Five (5) percent rate increase for the pharmacy professional dispensing fee.
Approval Date: December 19, 2019
Effective Date: October 1, 2019
Topics: Financing & Reimbursement Prescription Drugs

Tennessee
changes to Hospital Presumptive Eligibility (HPE), modifications to Presumptive Eligibility (PE) for Pregnant Women, the Eligibility Process Reviewable Unit, and the state’s election to end the option to provide Presumptive Eligibility to children under age 1.
Approval Date: December 19, 2019
Effective Date: March 18, 2019

New York
APG updates to Hospital Outpatient (FMAP=50%)
Approval Date: December 19, 2019
Effective Date: July 1, 2019

Iowa
Amends ABP 5 to add additional benefits under the Basic Dental Package and to add Denture Benefits.
Approval Date: December 19, 2019
Effective Date: August 30, 2019
Topics: Dental Program Administration

District of Columbia

This amendment will authorize the District to reimburse the Medicaid RACs up to the highest contingency fee used under the Medicare RAC Program.

Approval Date: December 19, 2019
Effective Date: January 1, 2020

Montana
Proposes to allow the Division of Medicaid 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). This amendment also proposes to allow the Division of Medicaid to comply with the requirements outlined in Montana House Bill 86 regarding a 7-day supply limit for opioid naïve members
Approval Date: December 18, 2019
Effective Date: October 1, 2019
Topics: Current State Plan Prescription Drugs

Georgia
Proposes to make Graduate Medical Education (GME) paid claims Add-On Payments for Community Service Boards (CSBs) with GME programs that are accredited by the Accreditation Council for Graduate Medical Education (ACGME). 
Approval Date: December 18, 2019
Effective Date: July 1, 2019
Topics: Current State Plan Program Administration