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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 5571 - 5580 of 15820

Maine
Authorizes legislative changes (Main PL 2019, Ch. 530) to reimbursement for inpatient hospital services
Approval Date: June 23, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Kentucky
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow for hospital presumptive eligibility for a number of optional groups and authorizes 2 PE periods within a calendar year while waiting performance standards during the emergency. This SPA also waives all copays during the emergency. These changes also apply to the approved Alternative Benefit Plan. The SPA allows for broad use of telehealth with reimbursement based on the current face-to-face fee schedule. Prior authorization for medications and Preferred Drug List exceptions are modified under this SPA.
Approval Date: June 22, 2020
Effective Date: March 1, 2020
Topics: Benefits Cost Sharing Disaster Relief Eligibility Financing & Reimbursement Prescription Drugs

North Dakota
Updates the reimbursement methodology specific to vacancies within an intermediate care facility for individuals with intellectual disabilities (ICF/IID)
Approval Date: June 22, 2020
Effective Date: April 1, 2020
Topics: Financing & Reimbursement

California
Extends the Non-Designated Public Hospital Supplemental Fund program for the state fiscal year ending 2021
Approval Date: June 19, 2020
Effective Date: July 1, 2020
Topics: Program Administration

Michigan
This SPA is a technical clarification of the pharmacy copay limits implemented under SPA 18-0500
Approval Date: June 19, 2020
Effective Date: January 1, 2020
Topics: Individual CoPayments or Insurance Payments

Iowa
Updates the scope of the state's pharmacist-covered services in order to align with Iowa's new protocols for (1) pharmacists ordering and dispensing naloxone and nicotine replacement  therapy tobacco cessation products, and (2) pharmacists ordering and administering vaccines.
 
Approval Date: June 19, 2020
Effective Date: July 1, 2020
Topics: Current State Plan Program Administration

Nebraska
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to suspend cost sharing for testing services, testing-related services, and treatment for COVID-19 (including vaccines, specialized equipment and therapies); Suspends premiums for Working Disabled and TMA; Allow Home health to be ordered and plans of care authorized by new provider types (Nurse Practitioner, Physician Assistant, Clinical Nurse Specialist; and Nurse Midwife); Increase the NF bedhold to 90 days provided the bed has not been filled; Add teledentistry reevaluation - post operative visit; and add codes and rates for teledentistry services added.
Approval Date: June 18, 2020
Effective Date: March 1, 2020
Topics: Benefits Cost Sharing Disaster Relief Eligibility Financing & Reimbursement

Nebraska
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to suspend all cost sharing for all eligibility groups effective May 1, 2020, through the remainder of the public health emergency.
Approval Date: June 18, 2020
Effective Date: May 1, 2020
Topics: Cost Sharing Disaster Relief Eligibility

Nevada
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to add the COVID-19 testing group under 1902(a)(10)(A)(ii)(XXIII) of the Act; Allow individuals who are evacuated from the state, who leave the state for medical reasons related to the disaster or public health emergency, or who are otherwise absent from the state due to the disaster or public health emergency and who intend to return to the state continue to be residents of the state under 42 CFR 435.403(j)(3); Implement lab benefit flexibilities under 42 CFR 440.30(a) and 42 CFR 440.30(b); and Allow for 100 percent Medicaid reimbursement in accordance with Medicare reimbursement for COVID-19 laboratory testing procedure codes.
Approval Date: June 18, 2020
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief Eligibility Financing & Reimbursement

Oregon
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to designate Contracted Community Partner organizations as qualified entities to make presumptive eligibility determinations; consider individuals evacuated from the state due to the emergency to continue to be residents; allow flexibility for mobile testing for COVID-19; and waive medication supply limits when appropriate to reduce exposure risk. In addition, this amendment will allow for changes in reimbursement policies and adjustment of payment rates for certain services and providers.
Approval Date: June 18, 2020
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief Eligibility Financing & Reimbursement Prescription Drugs