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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 5551 - 5560 of 15693

Colorado
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to provide flexibilities in the areas of home health, transportation, telemedicine, inpatient hospital services, and pharmacy benefits.
Approval Date: May 20, 2020
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief Prescription Drugs

Northern Mariana Islands
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, continue to consider residents who leave the Territory due to the disaster residents of the Territory, extend the reasonable opportunity period, allow 90-day supplies of drugs and early refills, extend all prior authorizations for medications without clinical review, or time/quantity extensions, allow exceptions to the Territory's preferred drug list in case of shortages, and allow use of telehealth methods in lieu of face-to-face reimbursed at 80% of the face-to-face rate.
Approval Date: May 20, 2020
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief Eligibility Financing & Reimbursement Prescription Drugs

Northern Mariana Islands
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to apply less strict income methods for determining eligibility, allow the SMA, hospital and public health centers to make presumptive eligibility (PE) decisions, and allow 12 months continuous eligibility for children under age 19.
Approval Date: May 20, 2020
Effective Date: March 1, 2020
Topics: Disaster Relief Eligibility

Missouri
Proposes to update the provider fee schedule to add behavioral health services with an effective date of January 1, 2020
Approval Date: May 20, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Minnesota
Reinstates the Recovery Audit Contractor (RAC) Program
Approval Date: May 19, 2020
Effective Date: September 1, 2019
Topics: Current State Plan Program Administration

New Jersey
Exception to Medicaid Recovery Audit Contractor Program Requirements
Approval Date: May 18, 2020
Effective Date: January 1, 2020
Topics: Program Administration

Iowa
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, allow for flexibility in hospital presumptive eligibility, suspend cost sharing and premiums for all services for all beneficiaries, add new services under 1915(i), and allow for other flexibilities in the 1915(i) program.
Approval Date: May 18, 2020
Effective Date: March 1, 2020
Topics: Benefits Cost Sharing Disaster Relief Eligibility Premiums

North Carolina
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to eliminate all cost sharing for testing and treatment that may be COVID-19 related, suspend enrollment fees and monthly premiums for the Health Care for Workers with Disabilities (HCWD) program; allow increased payment rates of 5% to certain FFS programs; add a 5% additional rate increase to support specific providers who may be experiencing a disproportionate impact; set payment rates for telehealth; and add an interim payment methodology.
Approval Date: May 18, 2020
Effective Date: March 1, 2020
Topics: Cost Sharing Disaster Relief Financing & Reimbursement Premiums

Utah
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, Expand Hospital Presumptive Eligibility to uninsured individuals for COVID-19 testing and related services, and Waive cost sharing for testing services (including in-vitro diagnostic products), testing- related services, and treatments for COVID-19, including vaccines, specialized equipment and therapies.
Approval Date: May 18, 2020
Effective Date: March 18, 2020
Topics: Cost Sharing Disaster Relief Eligibility

Michigan
Allows Tribal Health Centers (THCs) to become Tribal Federally Qualified Health Centers (Tribal FQHCs) and be reimbursed under an alternative Payment Methodology (APM).
Approval Date: May 18, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement