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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 4511 - 4520 of 15692

North Carolina
Effective July 1, 2021, this amendment revises inpatient payment methodology for Medical and Remedial Care and Services. Specifically, this revision to methodology includes incorporating enhanced Base Rates for inpatient claims reimbursement, Graduate Medical Education (GME) payment methodology, and Disproportionate Share Hospital (DSH) payments.
Approval Date: June 29, 2021
Effective Date: July 1, 2021
Topics: Allocation Methodologies Financing & Reimbursement

Vermont
Effective October 1, 2020 until September 30, 2025; pursuant to 1905(a)(29) of the Social Security Act and Section 1006(b) of the SUPPORT Act, this amendment adds medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan.
Approval Date: June 29, 2021
Effective Date: October 1, 2020

Indiana
This amendment proposes to add medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan.
Approval Date: June 28, 2021
Effective Date: October 1, 2020

Oklahoma
This state plan amendment amends the reimbursement methodology for federally qualified health centers (FQHC) to separate reimbursement for long-acting reversible contraceptive (LARC) devices from the encounter rate.
Approval Date: June 28, 2021
Effective Date: September 1, 2021
Topics: Financing & Reimbursement

Michigan
adds medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid ABP state plan.
Approval Date: June 28, 2021
Effective Date: October 1, 2020

Wisconsin
This amendment will be modifying Wisconsin's payment methodology to nursing homes for COVID-19 Vaccines which are administered by skilled nursing facilities.
Approval Date: June 28, 2021
Effective Date: February 1, 2021
Topics: Financing & Reimbursement

Florida
Effective March 23, 2021, this amendment adds language to the Inpatient Hospital Reimbursement Methodology for Indirect Graduate Medical Education (IME) Payments for services outlined within the State Plan. This amendment has a fiscal impact with an expected increase of $168,393,723 in federal funds for federal fiscal year (FFY) 2020-2021 and an increase of $207,324,368 in federal funds for FFY 2021-2022.
Approval Date: June 28, 2021
Effective Date: March 23, 2021
Topics: Financing & Reimbursement

North Carolina
Effective July 1, 2021, this amendment redefines the payment limit to eligible medical professionals of UNC Health Care and ECU Physicians from a unique count of eligible medical professional providers to an aggregate dollar cap in preparation for the North Carolina Medicaid Transformation to Managed Care.
Approval Date: June 28, 2021
Effective Date: July 1, 2021
Topics: Financing & Reimbursement Managed Care

Utah
Effective July 1, 2021, this amendment updates the effective date on the introduction page regarding payment rates for certain services. 
Approval Date: June 28, 2021
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

North Carolina
Effective July 1, 2021, this amendment revises the methodology for calculating hospital specific Medicaid ratio of costs to charges (RCCs) in preparation for the North Carolina Medicaid Transformation to Managed Care. The amendment will also discontinue hospital outpatient supplemental payments, increase hospital RCCs, and define how to establish hospital RCC’s for new hospitals and changes of ownership.
Approval Date: June 28, 2021
Effective Date: July 1, 2021
Topics: Benefits Financing & Reimbursement Managed Care