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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 5161 - 5170 of 15690

New York
Statewide formulary-drugs for Opioid dependence agents and Opioid antagonists
Approval Date: October 21, 2020
Effective Date: July 1, 2020
Topics: Program Administration

South Dakota
Implements a 2.0 percent inflationary increase to the Health Home per member per month (PMPM) payment.
Approval Date: October 21, 2020
Effective Date: July 1, 2020

Mississippi
Removes the annual Autism Spectrum Disorder rate updates and to specify that the rates will remain the same as those that were in effect
Approval Date: October 21, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

Maine
Establishes an alternative payment methodology for Rural Health Clinics based on 100% of the average of the reasonable cost of providing MaineCare-covered services during calendar years 2016 and 2017 
Approval Date: October 20, 2020
Effective Date: January 1, 2020
Topics: Coverage Financing & Reimbursement

Mississippi
Adds coverage and reimbursement of Private Duty Nursing (PDN) services and Personal Care Services (PSC) for Early and Periodic Screening, Diagnosis and Treatment (EPSDT) eligible beneficiaries
Approval Date: October 19, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement Program Administration

New Hampshire

NEMT Change in Reimbursement Methodology

Approval Date: October 19, 2020
Effective Date: October 1, 2020
Topics: Financing & Reimbursement

Washington
Implements CMS guidance regarding Third Party Liability as outlined in the Bipartisan Budget Act (BBA) of 2018
Approval Date: October 19, 2020
Effective Date: July 1, 2020
Topics: Program Administration

Vermont
VT submitted this SPA to update the ABP for the new adult group in order to ensure alignment with the full Medicaid State Plan by referencing the new state plan section (G1 – G3) that describes cost-sharing requirements for Medicaid beneficiaries
Approval Date: October 19, 2020
Effective Date: October 1, 2016

North Dakota
Implements an increase to the professional fee schedule for vaccine administration under the Pediatric Immunization program.
Approval Date: October 19, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

Puerto Rico
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to provide coverage of Remdesivir and Convalescent Plasma therapy treatment for hospitalized patients with confirmed or suspected COVID-19.
Approval Date: October 19, 2020
Effective Date: October 1, 2020
Topics: Benefits Disaster Relief Prescription Drugs