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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 5451 - 5460 of 15693

Arkansas

Adjust the Durable Medical Equipment (DME) rates to comply with Section 1903(i)(27) of the Social Security Act (SSA).

Approval Date: June 18, 2020
Effective Date: April 1, 2020
Topics: Financing & Reimbursement

Texas
Amendment updates the physicians and other practitioners fee schedule.
Approval Date: June 18, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Minnesota
This SPA updates the nursing facility rates as follows:
  • Establishes a new property payment rate setting methodology for nursing homes that are approved for a moratorium.
  • Modifies the rate setting formula for bed relocations
  • Modifies the rate setting formula used to set rates for the consolidation of two or more nursing facilities for consolidations.
  • Adds building assessment costs for pre-approved clean energy projects to the pass-through portion of the payment rate on a time-limited basis.
  • Modifies the interim and settle-up rate setting for new buildings.
Approval Date: June 18, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Idaho
Updates the reimbursement methodology for Institutions for Mental Disease (IMDs), critical access hospitals (CAHs), in-state, out-of-state, and state-owned hospitals.
Approval Date: June 18, 2020
Effective Date: March 3, 2020
Topics: Financing & Reimbursement

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

Puerto Rico
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to disregard unemployment compensation benefits funded by the territory for the non-MAGI population
Approval Date: June 18, 2020
Effective Date: March 1, 2020
Topics: Disaster Relief Eligibility

New York
Applies a 1 % reduction uniformly across payments made under certain sections in the 4.19B section of the state plan.
Approval Date: June 17, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement Program Administration