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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 5531 - 5540 of 15693

Delaware
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to suspend all copayments and premiums for all beneficiaries, modify telehealth benefits and allow payment accordingly, adjust the day supply or quantity limit for covered outpatient drugs, expand Prior authorization for medications automatic renewal without clinical review, or time/quantity extensions, and make exceptions to their published Preferred Drug List if drug shortages occur.
Approval Date: May 27, 2020
Effective Date: March 1, 2020
Topics: Benefits Cost Sharing Disaster Relief Financing & Reimbursement Premiums Prescription Drugs

Virginia
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to consider individuals who are evacuated or absent from the state due to the disaster or public health emergency and who intend to return to the state, to continue to be residents of the state. The amendment makes adjustments to the day supply and quantity limit for covered outpatient medications and will make exceptions to their published Preferred Drug List if drug shortages occur. In addition, the amendment increases payment rates for nursing facilities, specialized care providers, and updates the dental fee schedule.
Approval Date: May 27, 2020
Effective Date: March 12, 2020
Topics: Benefits Disaster Relief Eligibility Financing & Reimbursement Prescription Drugs

Alabama
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to provide a 20% increase in per diem rates for all COVID-19 diagnosis patients for hospital inpatient stays due to increases in cost associated with staffing, supplies, social distancing standards and other factors.
Approval Date: May 27, 2020
Effective Date: March 1, 2020
Topics: Disaster Relief Financing & Reimbursement

Louisiana
Amends the provisions governing the definition of a public, non-rural community hospital, to include Thibodaux Regional Medical Center, formerly owned by a parish, city or other local government or instrumentality, after January 1, 2019.
Approval Date: May 27, 2020
Effective Date: January 1, 2020

New York
Proposes to update the rate methodology for private intermediate care facilities
Approval Date: May 26, 2020
Effective Date: July 1, 2014
Topics: Financing & Reimbursement

Utah
Updated the utilization trend for the outpatient hospital Upper Payment Limit (UPL) in state fiscal year (SFY) 2021
Approval Date: May 26, 2020
Effective Date: July 1, 2020
Topics: Current State Plan Financing & Reimbursement

Arizona
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to approve certain interim payments to hospitals, to make technical corrections to a previously-approved benefit adjustment, and to clarify the effective date for the previously-approved new optional eligibility group.
Approval Date: May 22, 2020
Effective Date: March 1, 2020
Topics: Disaster Relief Eligibility Financing & Reimbursement

Minnesota
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to adopt the following less restrictive income methodologies: Disregard from income, any payment made by a state, local or tribal government to relieve the adverse economic impacts of the COVID-19 pandemic for certain eligibility groups, and Disregard from assets the payments of a state, local or tribal government to relieve the adverse economic impacts of the COVID-19 pandemic that are retained following the month of receipt during the disaster period, and/or retained following the disaster period for certain eligibility groups.
Approval Date: May 22, 2020
Effective Date: March 13, 2020
Topics: Disaster Relief Eligibility

New Hampshire
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing and to allow hospitals to make presumptive eligibility determinations for this population.
Approval Date: May 22, 2020
Effective Date: March 18, 2020
Topics: Disaster Relief Eligibility

New Mexico
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to increase base payments to nursing homes
Approval Date: May 22, 2020
Effective Date: April 2, 2020
Topics: Disaster Relief Financing & Reimbursement