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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 4971 - 4980 of 15693

Kansas
Updates the fee schedule to add two EPSDT counseling codes, effective January 1, 2021. 
Approval Date: January 12, 2021
Effective Date: January 1, 2021
Topics: Financing & Reimbursement

Alaska
This amendment makes permanent the authority to allow various provider types to order laboratory and radiology services.  In addition, the state adds coverage of heart and lung transplants for adults and all medically necessary transplants for children under 21 year of age within the inpatient hospital benefit.  
Approval Date: January 12, 2021
Effective Date: October 1, 2020
Topics: Program Administration

Ohio
Includes the Ohio Department of Rehabilitation and Corrections in the list of qualified entities eligible to make Presumptive Eligibility (PE) determinations for Pregnant Women, Children, Adults, Parents or Caretaker Relatives, and the Former Foster Care Group.
Approval Date: January 8, 2021
Effective Date: April 1, 2020
Topics: Program Administration

Kansas
Adds maternal depression screening to the benefits covered under the screening benefit category in Kansas’ State plan
Approval Date: January 8, 2021
Effective Date: January 1, 2021

Oklahoma
This SPA establishes coverage and reimbursement of rehabilitation residential substance use disorder (SUD) services in a non-IMD facility.
Approval Date: January 7, 2021
Effective Date: October 1, 2020
Topics: Financing & Reimbursement

Georgia
Ground Ambulance Upper Payment Limit (UPL) Supplemental Payment Program (Fee-For-Service)
Approval Date: January 7, 2021
Effective Date: January 1, 2021
Topics: Program Administration

Missouri
technical correction of web a address.
Approval Date: January 7, 2021
Effective Date: October 1, 2020
Topics: Program Administration

Utah
This SPA allows a bundled payment methodology for rehabilitative mental health services when provided in crisis receiving centers.  It also clarifies the purpose of rehabilitative mental health services including psychiatric diagnostic evaluation as for the direct benefit of the beneficiary.
Approval Date: January 7, 2021
Effective Date: October 1, 2020
Topics: Benefits Financing & Reimbursement

Kansas
Updates the fee schedule to include a two-tiered reimbursement system for Emergency Room (ER) professional services.
Approval Date: January 6, 2021
Effective Date: January 1, 2021
Topics: Program Administration Reimbursement

North Carolina
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to amend its state plan for four changes; three of which involve rate increases and an enhanced rate for NEMT providers during the PHE, and one providing authority to make quarterly payments to MRI/DSH/GAP payments to hospital providers.
Approval Date: January 5, 2021
Effective Date: March 1, 2021
Topics: Disaster Relief Reimbursement