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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 5441 - 5450 of 15693

Pennsylvania
Authorizes a supplemental payment to qualifying inpatient hospitals operating nursing schools
Approval Date: June 24, 2020
Effective Date: April 19, 2020
Topics: Current State Plan Financing & Reimbursement

Oklahoma
Separates and differentiates between services provided in a school setting under EPSDT versus those school-based services provided pursuant to an Individual Education Plan (IEP).
Approval Date: June 24, 2020
Effective Date: September 1, 2020
Topics: Benefits Current State Plan Program Administration

Montana
Updates fee schedule reimbursement as of March 1, 2020 for targeted case management services: (1) Youth with Serious Emotional Disturbance (SED, (2) Youth with SED in an Out-of-State PRTF, (3) Adults with Severe Disabling Mental Illness, (4) Substance Use
Disorders (SUD) – Youth and (5) SUD - Adult.
Approval Date: June 23, 2020
Effective Date: March 1, 2020
Topics: Financing & Reimbursement Rebate/Reimbursement Updates

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

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

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

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

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

Idaho
Removes the state’s 1915(l) option from the state plan, as Idaho is transitioning coverage of substance use disorder (SUD) treatment in institutions of mental disease from the state plan to the state’s SUD section 1115(a) demonstration, known as Idaho Behavioral Health Transformation
Approval Date: June 18, 2020
Effective Date: April 17, 2020