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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 4071 - 4080 of 15693

Montana
revises the coverage location of Applied Behavior Analysis (ABA) services in the state plan, clarifies that ABA services are provided for individuals under the age of 21 pursuant to EPSDT, clarifies the qualified practitioners that can furnish ABA services in Montana, and makes conforming changes to the corresponding reimbursement pages.
Approval Date: December 16, 2021
Effective Date: August 1, 2021

California
provides full Medicaid coverage to all beneficiaries int he  Pregnant women eligibility group
Approval Date: December 16, 2021
Effective Date: January 1, 2022

Montana
Change the maximum dispensing fee for each tier, to accurately reflect the provider rate increase appropriated by the Montana legislature. 
Approval Date: December 16, 2021
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

Colorado
Modifies the services that licensed pharmacies can receive reimbursement.
Approval Date: December 16, 2021
Effective Date: September 6, 2021

Georgia
Modify the average commercial rate calculation and frequency of data collection used in the calculation of ambulance supplemental payments.
Approval Date: December 16, 2021
Effective Date: No Effective Date

Georgia
Remove the provision which prohibits a physician from receiving supplemental payments through the Fee-for-Service Physician Upper Payment Limit (UPL) program and the enhanced primary care reimbursement rates simultaneously.
Approval Date: December 16, 2021
Effective Date: October 1, 2021
Topics: Financing & Reimbursement

Iowa
permits IHS and Tribal facilities to claim Medicaid reimbursement under the FQHC services benefit, including the IHS All Inclusive Rate, provided outside the “four wall” of the facility.
Approval Date: December 16, 2021
Effective Date: October 1, 2021

Massachusetts
Adds EPSDT preventative behavioral health services and established the methods and standards used to set payment rates.
Approval Date: December 16, 2021
Effective Date: September 1, 2021
Topics: Financing & Reimbursement

Massachusetts

This SPA updates the providers who are able to prescribe or order durable medical equipment.

Approval Date: December 15, 2021
Effective Date: August 6, 2021

Maine
Updates the requirements for Independent Practice Dental Hygienists when they are submitting for reimbursement to MaineCare for temporary fillings, by removing two outdated consent and referral forms.
Approval Date: December 15, 2021
Effective Date: July 1, 2021