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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 4681 - 4690 of 15690

South Carolina
This Supplemental Teaching Physician (STP) SPA updates the base year used to determine payments under the Average Commercial Rate(ACR) method. This Plan amendment excludes Greenville, Richland/USC.
Approval Date: May 20, 2021
Effective Date: April 1, 2019
Topics: Financing & Reimbursement

Texas
Updates the durable medical equipment, prosthetics, orthotics, supplies (DMEPOS) fee schedule.
Approval Date: May 19, 2021
Effective Date: March 1, 2021
Topics: Medical Supplies & Devices

Texas
updates the physicians’ and other practitioners’ fee schedules.
Approval Date: May 19, 2021
Effective Date: March 1, 2021
Topics: Financing & Reimbursement

West Virginia
Exception from the Medicaid Recovery Audit Contractor (RAC) requirements.
Approval Date: May 19, 2021
Effective Date: January 1, 2021

Washington
update to reimbursement rates for individual providers and agency providers
Approval Date: May 19, 2021
Effective Date: January 1, 2021
Topics: Financing & Reimbursement

Washington
updated the fee schedule effective dates for several Medicaid programs and services.
Approval Date: May 19, 2021
Effective Date: January 1, 2021
Topics: Financing & Reimbursement

Oklahoma
Effective September 1, 2021, this amendment modifies the Other Licensed practitioner benefit to allow licensed psychologists to render applied behavior analysis (ABA) services within state scope of practice without previous ABA related national certification requirements. This action will allow additional state licensed psychologists to provide services within state scope of practice, permissible under the OLP benefit and will likely increase the provider pool, which would be beneficial to Medicaid eligible children with autism.
Approval Date: May 19, 2021
Effective Date: September 1, 2021

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 cap for supplemental disproportionate hospital share (DHS) payments to qualifying hospital providers.
Approval Date: May 19, 2021
Effective Date: July 1, 2020
Topics: Disaster Relief Reimbursement

Guam
This SPA adopts the option to provide Medicaid eligibility without a 5-year waiting period to otherwise eligible individuals who lawfully reside in Guam in accordance with the Compacts of Free Association (COFA) between the Government of the United States and the Governments of the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau
Approval Date: May 19, 2021
Effective Date: January 1, 2021

Maine
This amendment provides a special supplemental allowance to provide for increases in contract labor and allowable wages and associated benefits and taxes in the direct care and routine care cost component
Approval Date: May 19, 2021
Effective Date: July 1, 2020