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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 4991 - 5000 of 15693

Florida
Includes language regarding Multi-Visceral Transplant Reimbursement for services outlined within the State Plan updating the global facility rate for multi-visceral transplants and intestine transplants
Approval Date: December 23, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

South Carolina
Provides an increase to the current home based private duty nursing services rates, vision services rates, and anesthesia services codes for services provided
Approval Date: December 23, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

Wisconsin

Proposed to eliminate cost sharing for individuals under 19 years old and to implement a tracking system to comply with the statutory and regulatory cost sharing tracking requirements in section 1916A of the Social Security Act (“Act”).

Approval Date: December 23, 2020
Effective Date: July 1, 2020

Florida
Updates Enhanced Ambulatory Patient Group (EAPG) reimbursement rates for hospital outpatient services and makes 
 
Approval Date: December 23, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

Washington
This SPA removes language regarding client copayments. The copayment policy was not implemented, therefore the co-pay information is outdated and does not reflect current state agency policy 
Approval Date: December 23, 2020
Effective Date: October 1, 2020
Topics: Individual CoPayments or Insurance Payments

Mississippi
Allows the Division of Medicaid to add coverage of licensed pharmacists under the Other Licensed Practitioners (OLP) for vaccine administration.
Approval Date: December 23, 2020
Effective Date: September 1, 2020

Minnesota

Revised state plan language to modify the requirements for the sue of telemedicine and allows additional practitioners to deliver services via telemedicine.

Approval Date: December 23, 2020
Effective Date: October 1, 2020

New York
Care Coordination Organization/ Health Home (CCO/HH) Program
Approval Date: December 22, 2020
Effective Date: July 1, 2020
Topics: Program Administration

Illinois
provide a rate increase for mental health and substance use disorder services
Approval Date: December 22, 2020
Effective Date: September 1, 2020
Topics: Financing & Reimbursement

Colorado
Allows outpatient hospital-rates to be decreased by one percent
Approval Date: December 22, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement