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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 5471 - 5480 of 15693

Colorado
Decreases clinical diagnostic laboratory rates on a per-test basis to align with Medicare rates in accordance with the Social Security Act Section 1903(i)(7)
Approval Date: June 15, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Texas
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to increase payment rates for certain supplies, imaging and testing services and Nursing Facility services. This will now be equal to the Medicare reimbursement rate. Payment increases for the nursing facility are temporarily increased though the current Medicaid RUG rates. HHSC increased the direct care staff average hourly wage by $2 per hour and increased the Supplies and Dietary categories by 50%. Lastly, this SPA added a temporary add-on supplemental payment for nursing facilities to support increased costs due to COVID-19.
Approval Date: June 15, 2020
Effective Date: April 1, 2020
Topics: Disaster Relief Financing & Reimbursement

Vermont
revises the annual cap on dental benefits from $510 to $1,000 per beneficiary per calendar year
Approval Date: June 12, 2020
Effective Date: January 1, 2020

Ohio
Updates provisions related to cost reporting for nursing facilities, and to make other changes for clarity and concision
Approval Date: June 12, 2020
Effective Date: March 23, 2020
Topics: Financing & Reimbursement Program Administration

Wisconsin
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to provide for an extension of the reasonable opportunity period for non-citizens declaring to be in a satisfactory immigration status and to allow licensed practitioners practicing within their scope of practice such as nurse practitioners and physicians assistants, to order home health services.
Approval Date: June 12, 2020
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief Eligibility

Wisconsin
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow exceptions to the state's preferred drug list when shortages occur.
Approval Date: June 12, 2020
Effective Date: March 23, 2020
Topics: Benefits Disaster Relief Prescription Drugs

Wisconsin
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover the suspend all cost sharing for the Work Incentives group under 1902(a)(10)(A)(XIII) of the Social Security Act and extend all prior authorization by automatic renewal without clinical review or time/quantity extensions, and allow automatic renewal of prior authorization for medications without clinical review or time/quantity extensions.
Approval Date: June 12, 2020
Effective Date: April 1, 2020
Topics: Benefits Cost Sharing Disaster Relief Eligibility Prescription Drugs

Maine
Reduces rates for Licensed Clinical Professional Counselors and Licensed Marriage and Family Therapists
Approval Date: June 12, 2020
Effective Date: March 29, 2013
Topics: Financing & Reimbursement

Arkansas
The Arkansas Department of Human Services (DHS), Division of Medical Services (DMS) will amend the Medicaid maximum unit reimbursement rate for personal care services
Approval Date: June 12, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Maine
This amendment increases rates for Licensed Clinical Professional Counselors and Licensed Marriage and Family Therapists
Approval Date: June 12, 2020
Effective Date: July 1, 2013
Topics: Financing & Reimbursement