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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 4331 - 4340 of 15693

Massachusetts
This plan amendment provides updates to the rate of payment for hearing services. This SPA is making changes to (1) increase rates for certain hearing services covered by an adjustment of 9.66%; (2) incorporate certain cochlear implant device related services and increase these rates by an adjustment of 9.66%; and (3) establish service-specific codes and rates for bone-anchored hearing aid (BAHA) services.
Approval Date: September 17, 2021
Effective Date: June 1, 2021
Topics: Financing & Reimbursement

Mississippi
Allows the Division of Medicaid (DOM) to set the fees for DPSDT extended services to the same as those in effect on July 1, 2020, to remove the five percent (5%) reimbursement reduction effective July 1, 2021, and add coverage and reimbursement of Mississippi Youth Programs Around the Clock (MYPAC) Therapeutic Services effective July 1, 2021.
Approval Date: September 17, 2021
Effective Date: July 1, 2021
Topics: Coverage and Reimbursement

Maine
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to 1) Add emergency medical technicians (EMTs) to administer COVID-19 vaccinations, 2) Revise reimbursement to 100% of the Medicare rate for vaccine administration and 70% of the Medicare rate for testing services and telehealth, 3) Provide a one-time supplemental payment of $14,607,582.00 to behavioral health services providers, and 4) Add Code G2025 for RHC/FQHC telehealth services
Approval Date: September 16, 2021
Effective Date: March 1, 2020

North Dakota
Adds coverage for clinically managed residential withdrawal services and medically monitored intensive impatient treatment
Approval Date: September 16, 2021
Effective Date: October 1, 2020

Washington
Allows the state to transfer the administrative functions and responsibilities of personal care and respite Individual Provider (IP) management from the Department of Social and Health Services (DSHS) and Area Agency on Aging (AAA) staff to a single contracted CDE vendor, the Consumer Direct Care Washington, LLC.
Approval Date: September 16, 2021
Effective Date: October 1, 2021
Topics: Coverage Financing & Reimbursement

Virginia
Increases the rates for psychiatric services, anesthesiologists, and supplemental physician payments 
Approval Date: September 15, 2021
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

California
Adds Medication Therapy Management (MTM) to Licensed Pharmacist Services under the Other Licensed Practitioner (OLP) benefit; remove the Treatment Authorization Request (TAR) requirement from Licensed Pharmacist Services; and updates the rate methodology for Licensed Pharmacist Services by adding rates for MTM
Approval Date: September 15, 2021
Effective Date: July 1, 2021

Illinois
Proposes to increase encounter rates for FQHCs
Approval Date: September 15, 2021
Effective Date: April 1, 2021
Topics: Financing & Reimbursement

California
updates to the Skilled Nursing Facility Quality and Accountability Supplement Payment (QASP) for the rate periods from August 1, 2020 to December 31, 2021
Approval Date: September 13, 2021
Effective Date: August 1, 2021
Topics: Program Administration

Georgia
increases the rates for specialized nursing home mechanical ventilator care.
Approval Date: September 13, 2021
Effective Date: July 1, 2021
Topics: Financing & Reimbursement