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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 4371 - 4380 of 15693

Colorado
allows durable medical equipment (DME) subject to the upper payment limit described in Section 1903(i)(27) of the Social Security Act to be reimbursed at or below 100% of the Medicare rates.
Approval Date: September 1, 2021
Effective Date: January 1, 2021
Topics: Benefits Financing & Reimbursement

Missouri
updates the fee schedule rates for both governmental and private providers of Air Ambulance services.
Approval Date: September 1, 2021
Effective Date: July 1, 2021
Topics: Program Administration

Missouri
removes all cost sharing, co-payments and deductibles from the Medicaid state plan
Approval Date: September 1, 2021
Effective Date: July 1, 2021
Topics: Program Administration

Idaho
modify the Case Management reimbursement and structure for the Primary Care Case Management Program known as Healthy Connections, and align it with the Healthy Connections Value Care Program.
Approval Date: August 31, 2021
Effective Date: July 1, 2021
Topics: Program Administration

Missouri
reinstates Missouri’s Program of All-Inclusive Care for the Elderly (PACE)
Approval Date: August 31, 2021
Effective Date: July 1, 2021
Topics: Program Administration

Mississippi
allow the Division of Medicaid to 1) set the fees for vaccines and vaccine administration the same as those effective for State Fiscal Year 2021, 2) to include language regarding the reimbursement for administration of Vaccine For Children (VFC) vaccines, and 3) remove the five percent reimbursement reduction
Approval Date: August 31, 2021
Effective Date: July 1, 2021
Topics: Program Administration

Maryland
adds medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan.
Approval Date: August 30, 2021
Effective Date: October 1, 2020
Topics: Benefits Medicaid Expansion Program Administration

North Dakota
This plan amendment allows the state to implement an inflationary increase for Personal Care Services.
Approval Date: August 29, 2021
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

Missouri
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 provide a per diem increase to nursing facility and HIV nursing facility per diem reimbursement rates of ten dollars and eighteen cents ($10.18) effective for dates of service July 1, 2021 through June 30, 2022.
Approval Date: August 27, 2021
Effective Date: July 6, 2021
Topics: Disaster Relief Reimbursement

Texas
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 allow for the administration of the COVID-19 vaccine to be reimbursed at a set fee equal to the same amount approved for the vaccine administration in a physician’s office and outside of the daily case mix rate of Nursing Facilities.
Approval Date: August 27, 2021
Effective Date: December 11, 2020
Topics: Disaster Relief Reimbursement