U.S. flag

An official website of the United States government

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 1931 - 1940 of 15696

Maryland

Modifies the language that describes the rate categories for the Program of All-Inclusive Care for the Elderly (PACE) by removing the QMB rates in the rate-setting methodology. This change does not fundamentally change the formula for rate calculation.

Approval Date: September 8, 2023
Effective Date: July 1, 2023
Topics: Benefits Quality of Care

Utah

This SPA proposes to allow the state to enter into value-based contracts with manufacturers.

Approval Date: September 8, 2023
Effective Date: April 1, 2023
Topics: Covered Outpatient Drug Preferred Drug Lists Prescribed Drugs Supplemental Rebates and Managed Care Value Based Purchasing

Iowa

Implement individual mental health therapy provider and substance use disorder (SUD) rate increase authorized by Senate File 561.

Approval Date: September 8, 2023
Effective Date: July 1, 2023

Alabama

This SPA proposes to update the state's Excluded Drug list, to include amending the language provisions for coverage of selective non-prescription covered outpatient drugs.

Approval Date: September 7, 2023
Effective Date: June 1, 2023
Topics: Prescribed Drugs Reimbursement

Michigan

This SPA provides authority to cover and to reimburse for Psychiatric Residential Treatment Facility (PRTF) services for eligible Michigan Medicaid beneficiaries.

Approval Date: September 7, 2023
Effective Date: December 1, 2023

Oregon

To increase the rate for NEMT mileage, meals, and lodging and base them on a percentage of the IRS standard rates.

Approval Date: September 6, 2023
Effective Date: April 1, 2023

New Hampshire

Effective May 30, 2023, this amendment provides for coverage and reimbursement for psychiatric residential treatment facility (PRTF) services.

Approval Date: September 5, 2023
Effective Date: May 30, 2023

West Virginia

This state plan amendment clarifies coverage of crisis intervention services and service rates.

Approval Date: September 5, 2023
Effective Date: July 1, 2023
Topics: Benefits Reimbursement

Oklahoma

This amendment proposes to add secure mental health transportation services to Oklahoma’s Medicaid State Plan.

Approval Date: September 5, 2023
Effective Date: July 1, 2023
Topics: Coverage Reimbursement Transportation

Vermont

This amendment establishes Vermont’s ability to enter into value-based supplemental rebate agreements with drug manufacturers.

Approval Date: September 1, 2023
Effective Date: April 1, 2023
Topics: Additional Rebate Covered Outpatient Drug Prescription Drugs Supplemental Rebates and Managed Care Value Based Purchasing