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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 4611 - 4620 of 15690

Missouri
This plan amendment increases the fee schedule rate for Ground Ambulance services.
Approval Date: June 7, 2021
Effective Date: October 1, 2020
Topics: Financing & Reimbursement

Virginia
Effective March 1, 2021, this amendment solicits advice from Tributes and Indian Health Programs, prior to submitting any plan amendments, waiver requests, and proposals for demonstration projects that are likely to have a direct effect on Indians, Indian Health Programs, or Urban Indian Organizations. 
Approval Date: June 7, 2021
Effective Date: March 1, 2021
Topics: Program Administration Tribal Issues

Ohio
Effective January 17, 2021, this amendment includes coverage, limitations, and payment for services when services are provided by a Pharmacist. 
Approval Date: June 7, 2021
Effective Date: January 17, 2021
Topics: Benefits Coverage Financing & Reimbursement

District of Columbia
Effective October 1, 2020,  this amendment permits the District of Columbia to provide medication-assisted treatment (MAT) for opioids use disorder (OUD) as a mandatory state plan benefit in compliance with section 1006(b) of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act). The SPA assures that the District covers as a mandatory benefit all FDA approved MAT drugs, FDA licensed MAT biological products, and MAT behavioral counseling and therapy services.
Approval Date: June 7, 2021
Effective Date: October 1, 2020
Topics: Benefits Program Administration

Maryland
Effective January 1, 2021, this amendment decreases select Durable Medical Equipment (DME)/ Disposable Medical Supplies (DMS) codes from 85 percent to 80 percent of the current Medicare rates while clarifying payment for DME/DMS where no Medicare fee exists.
Approval Date: June 5, 2021
Effective Date: January 1, 2021
Topics: Financing & Reimbursement Program Administration

American Samoa
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 the territory to consider individuals absent from the territory to continue to be residents; to provide rate increases for FQHC medical encounters rendered at government quarantine locations; to create payment methodology for local non-government dialysis centers in AS during the PHE period; to revise the payment methodology for off-island dialysis; and to revise payment methodology for transportation and related accommodations associated with return from off-island medical care.
Approval Date: June 4, 2021
Effective Date: March 1, 2020
Topics: Disaster Relief Eligibility Reimbursement

California
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 disregard as income and disregard as resources any payments received from a Golden State Stimulus or a Golden State Grant for 12 months after receipt.
Approval Date: June 4, 2021
Effective Date: February 23, 2021
Topics: Disaster Relief Eligibility

Pennsylvania
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 add pharmacists' services to other practitioners' services, to allow licensed pharmacists, pharmacy interns, and pharmacy technicians to administer COVID-19 vaccines, consistent with their scope of practice. Effective December 1, 2020, the state will pay a rate equivalent to the Medicare rate for administration of COVID-19 vaccines.
Approval Date: June 4, 2021
Effective Date: October 1, 2020
Topics: Benefits Disaster Relief Reimbursement

Puerto Rico
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 authorize pharmacies, pharmacists, pharmacy interns, and pharmacy techs to administer the COVID vaccination under the preventive services benefit. The SPA also updates the reimbursement methodology for vaccine administration.
Approval Date: June 4, 2021
Effective Date: April 1, 2021
Topics: Benefits Disaster Relief Reimbursement

Wisconsin
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 increase the COVID-19 vaccine administration payment rates to align with Medicare rates and allow other licensed practitioners such as pharmacists and pharmacy interns to administer the vaccine.
Approval Date: June 4, 2021
Effective Date: December 11, 2020
Topics: Benefits Disaster Relief Reimbursement