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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 5901 - 5910 of 15843

Michigan

Changes to the state's Pharmacy DUR language in compliance with the SUPPORT Act.

Approval Date: March 11, 2020
Effective Date: October 1, 2019
Topics: Current State Plan Prescription Drugs Program Administration

Maine
Updates the outpatient hospital supplemental pool reimbursement description
Approval Date: March 11, 2020
Effective Date: November 14, 2019
Topics: Financing & Reimbursement

Oklahoma
Removes copays for medication assisted treatment (MAT) drugs for opioid use
Approval Date: March 11, 2020
Effective Date: January 1, 2020
Topics: Individual CoPayments or Insurance Payments Prescribed Drugs

Oregon
revise the Behavioral Health rehabilitation and include a level of care for Intensive In-Home Behavioral Health Services as a part of Oregon’s services for children’s behavioral health.
Approval Date: March 11, 2020
Effective Date: July 1, 2020

Louisiana
amends provisions governing the Pharmacy Benefits Management program in order to allow the state to pursue out-comes based agreements with manufacturers and to align the provisions with the current Medicaid State plan.
Approval Date: March 11, 2020
Effective Date: March 11, 2020
Topics: Benefits Pharmacy Benefit Managers (PBMs)

North Carolina

Revises North Carolina’s End State Renal Disease (ESRD) program’s policies and titles to expand dialysis to patients diagnosed with Acute Kidney Injuries (AKI).

Approval Date: March 10, 2020
Effective Date: January 1, 2020

Nebraska
This SPA describes the methodology used by the state for determining the appropriate FMAP rates, including the increased FMAP rates, available under the provisions of the Affordable Care Act applicable for the medical assistance expenditures under the Medicaid program associated with enrollees in the new adult group adopted by the state and described in 42 CFR 435.119.
Approval Date: March 10, 2020
Effective Date: October 1, 2020

Nebraska
This SPA adds coverage for the eligibility group for adults with income below 133% of the FPL under Section 1902(a)(10)(A)(viii) of the Social Security Act
Approval Date: March 10, 2020
Effective Date: October 1, 2020
Topics: Current State Plan Eligibility Program Administration

Utah
Updates the reimbursement for outpatient hospital dialysis to the same rate as the Medicare End Stage Renal Disease (ESRD) Prospective Payment System (PPS) Base Rate after the initial outpatient hospital encounter
Approval Date: March 10, 2020
Effective Date: January 13, 2020
Topics: Financing & Reimbursement

Nevada
Consolidates the supervision of the Peer Supporter under the Clinical Supervisor with the Behavioral Health Community Network (BHCN) and removes the requirement of medical supervision for the provider
Approval Date: March 10, 2020
Effective Date: January 1, 2020
Topics: Current State Plan Program Administration