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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 5681 - 5690 of 15690

Oregon
Proposes a COVID-19 increase to nursing facility ventilator rates
Approval Date: April 10, 2020
Effective Date: March 20, 2020
Topics: Financing & Reimbursement

Oregon
increased the telemedicine/Telehealth rates due to the COVID-19 Public Health Emergency (PHE) and will sunset at the end of the PHE.
Approval Date: April 10, 2020
Effective Date: March 1, 2020
Topics: Financing & Reimbursement

Arizona
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purposes of this amendment is to allow physicians and other licensed practitioners, in accordance with state law, to order Medicaid Home Health services and to allow payments for a reserved bed to be made if the absence does not exceed 30 days per contract year.
Approval Date: April 9, 2020
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief Financing & Reimbursement

Ohio
This SPA updates the narrative description of the interagency agreement between the Ohio Department of Medicaid and the Ohio Department of Developmental Disabilities
Approval Date: April 9, 2020
Effective Date: January 1, 2020

Arizona
Updates nursing facility rates effective January 1, 2020
Approval Date: April 9, 2020
Effective Date: March 30, 2020
Topics: Financing & Reimbursement

New Mexico

This amendment increases reimbursement rates for outpatient hospital services.

Approval Date: April 8, 2020
Effective Date: July 1, 2019
Topics: Financing & Reimbursement

North Dakota
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purposes of this amendment is to suspend premiums for the Employed Individuals with Disabilities program eligibility group, make adjustments to prior authorization and the day supply or quantity limit for covered outpatient drugs, suspend the Qualified Service Provider qualifications regarding competency and state criteria, waive the timelines for nursing facility rate reconsiderations and appeals, and waive the 15 day limit for payment for a reserved bed for an inpatient hospitalization.
Approval Date: April 8, 2020
Effective Date: March 1, 2020
Topics: Disaster Relief Financing & Reimbursement Premiums Prescription Drugs

Rhode Island
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purposes of this amendment is to expand eligibility to cover COVID-19 testing for uninsured individuals, make other eligibility and enrollment changes, suspend premiums for the Employed Individuals with Disabilities program eligibility group, automatically renew prior authorization for medications, and adjust post eligibility treatment of income
Approval Date: April 8, 2020
Effective Date: March 1, 2020
Topics: Disaster Relief Eligibility Premiums Prescription Drugs

Illinois
Proposes a $4,375,000 increase to provide coverage of hospital services provided due to a lack of appropriate placement
Approval Date: April 8, 2020
Effective Date: January 1, 2020
Topics: Federal Financial Participation

California
Adds a new reimbursement methodology for the Drug Medi-Cal Organized Delivery System (DMC-ODS) Substance Use Disorder (SUD) services
Approval Date: April 7, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement