U.S. flag

An official website of the United States government

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 4571 - 4580 of 15690

New Mexico
Effective October 1, 2020, this amendment adds the new mandatory MAT benefit 1905 (a)(29) in compliance with section 106(b) of the SUPPORT Act. MAT services include all FDA-approved or licensed drugs and biologicals to treat opioid use disorder (OUD), counseling services and behavioral therapy. These MAT services will provide necessary treatment for Medicaid beneficiaries with OUD and help address the national opioid epidemic. 
Approval Date: June 16, 2021
Effective Date: October 1, 2020

Oregon
Effective April 1, 2021, this amends the state's coverage pages to include updates to covered over-the-counter items. 
Approval Date: June 16, 2021
Effective Date: April 1, 2021
Topics: Benefits Current State Plan

Missouri
This SPA proposes to add a reimbursement methodology for drugs purchased through the 340B drug program.
Approval Date: June 15, 2021
Effective Date: July 1, 2021

Georgia
Effective August 14, 2020, this amendment increases the reimbursement for ventilator dependent nursing facility residents. Specifically, this amendment proposes to increase the nursing facility per diem for a ventilator dependent resident by 3%. The rate will increase from $540.55 to $556.77. 
Approval Date: June 15, 2021
Effective Date: August 14, 2021

Georgia
Effective August 14, 2020, this amendment implements a quality incentive for nursing homes that receive national quality award status or accreditation. 
Approval Date: June 15, 2021
Effective Date: August 14, 2020

Wisconsin
Effective February 1, 2021, this amendment proposes to align Medicaid COVID-19 vaccine administration rates with Medicare rates and to allow other licensed practitioners such as pharmacists and pharmacy technicians to administer the COVID-19 vaccine. 
Approval Date: June 15, 2021
Effective Date: February 1, 2021

Connecticut
Effective January 1, 2021, this plan amendment revises the Medical Clinic, Family Planning Clinic, Behavioral Health Clinic, Rehabilitation Clinic, and Ambulatory Surgical Center fee schedules.
Approval Date: June 14, 2021
Effective Date: January 1, 2021
Topics: Financing & Reimbursement Program Administration

Connecticut
Effective January 1, 2021, this plan amendment revises the Independent Audiology fee schedule. These revisions incorporate the 2021 Healthcare Common Procedural Coding System (HCPCS) changes (additions, deletions and description changes) to remain compliant with the Health Insurance Portability and Accountability Act (HIPAA)
Approval Date: June 14, 2021
Effective Date: January 1, 2021
Topics: Financing & Reimbursement

Connecticut
Effective January 1, 2021, this plan amendment updated the dental fee schedules for adults and children. These updates incorporate various 2021 Healthcare Common Procedural Coding System (HCPCS) changes (additions, deletions and description changes) to remain compliant with the Health Insurance Portability and Accountability Act (HIPAA).
Approval Date: June 14, 2021
Effective Date: January 1, 2021
Topics: Benefits Dental Financing & Reimbursement

Connecticut
Effective February 1, 2021, this plan amendment updated the Durable Medical Equipment (DME) fee schedule to incorporate the 2021 Healthcare Common Procedural Coding System (HCPCS) changes (additions, deletions and description changes) to remain compliant with the Health Insurance Portability and Accountability Act (HIPAA).
Approval Date: June 14, 2021
Effective Date: February 1, 2021
Topics: Financing & Reimbursement