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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 4261 - 4270 of 15693

Pennsylvania
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to pay Federally Qualified Health Centers and Rural Health Centers for the administration of COVID-19 vaccines when the vaccines are not provided during the course of a billable encounter visit.
Approval Date: October 14, 2021
Effective Date: December 1, 2021
Topics: Disaster Relief Reimbursement

California
extends the Private Hospital Supplemental Fund program for the state fiscal year ending 2022.
Approval Date: October 14, 2021
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

Virginia
Expands the substance use disorder service called “Preferred Office-Based Opioid Treatment” which has been available only to individuals with a primary diagnosis of opioid use disorder to individuals with a substance-related or addictive disorder.
Approval Date: October 14, 2021
Effective Date: October 1, 2021

West Virginia
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to suspend the requirement for ambulance providers to transport beneficiaries to the nearest appropriate medical facility and to suspend the requirement for beneficiaries to be stretcher bound to use non-emergency ambulance services, to ensure that ambulance services and service destinations are not restricted during the public health emergency period.
Approval Date: October 13, 2021
Effective Date: August 1, 2021
Topics: Benefits Disaster Relief

Idaho
Reimbursement methodology for Targeted Case Managament for At-Risk children
Approval Date: October 13, 2021
Effective Date: July 1, 2020

Washington
Sole Community Inpatient Hospital Rates
Approval Date: October 13, 2021
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

New Jersey
Adds peer support and coordination services, which are provided to individuals after an opioid overdose, to the state’s Alternative Benefit Plan (ABP). These peer support and coordination services have been added to the benefit package in the Medicaid state
plan and this SPA would align the benefits of both benefit packages.
Approval Date: October 12, 2021
Effective Date: July 1, 2019

Washington
Managed Care Enrollment Process Update
Approval Date: October 12, 2021
Effective Date: July 1, 2021

Washington
extended the temporary rate increase of 150 percent of the hospital's fee-for-service rates that was originally implemented effective July 1, 2018, which is now extended through June 30, 2023, to then be returned to the payment levels and methodology for these hospitals that were in place as of January 1, 2018.
Approval Date: October 12, 2021
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

West Virginia
Adds medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan.
Approval Date: October 7, 2021
Effective Date: October 1, 2020