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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 4701 - 4710 of 15690

New Jersey
Update Medicaid Fee Schedules.
Approval Date: May 14, 2021
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

Idaho
Effective January 1, 2021, this amendment changes the methodology and thresholds for determining cost-effectiveness for Medicaid Estate Recovery and clarifies the definition of "recoverable medical assistance."
Approval Date: May 14, 2021
Effective Date: January 1, 2021
Topics: Program Administration Reimbursement

Virginia
Amends Durable Medical Equipment (DME) and Supplies
Approval Date: May 14, 2021
Effective Date: April 1, 2021
Topics: Medical Supplies & Devices

Alabama
This SPA incorporates the current version of the Program of All-Inclusive Care for the Elderly (PACE) State Plan Amendment preprint and provide State assurances that PACE rates are set at less than 100% of the amount that would otherwise have been paid for a comparable population.
Approval Date: May 13, 2021
Effective Date: May 1, 2021
Topics: Program Administration

Texas
Updates the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services fee schedule
Approval Date: May 13, 2021
Effective Date: March 1, 2021
Topics: Financing & Reimbursement

Wyoming
Adds the Optional Targeted Low Income Children eligibility group to the Medicaid state plan. This SPA is part of the state's transition of its separate Children's Health Insurance Program (CHIP) to a Medicaid expansion program.
Approval Date: May 13, 2021
Effective Date: October 1, 2020

Kansas
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 reimbursement for COVID-19 vaccine administration from $14.15 to $40.00.
Approval Date: May 12, 2021
Effective Date: April 1, 2020
Topics: Disaster Relief Reimbursement

Michigan
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 a temporary premium payment to be paid to specified providers for in-person care, modify additional payments for specific COVID-19 nursing facilities, and increase payment for the administration of Emergency Use Authority for investigational drugs, devices, and biological agents to 100% of the Medicare rate.
Approval Date: May 12, 2021
Effective Date: January 1, 2021
Topics: Disaster Relief Reimbursement

Michigan
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 an add on hospital payment for Remdesivir. In addition, this SPA provides authority to address the National Emergency by allowing for a temporary premium payment to be paid to specified providers for in-person care, modifying additional payments for specific COVID-19 nursing facilities, and increasing payment for the administration of Emergency Use Authority for investigational drugs, devices, and biological agents to 100% of the Medicare rate.
Approval Date: May 12, 2021
Effective Date: January 1, 2021
Topics: Disaster Relief Reimbursement

New York
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 make multiple adjustments to benefits currently covered in the state plan 1) to ensure individuals with mental health conditions are able to receive medically necessary mental health rehab services (see below); 2) allow providers in all situations to use a wide variety of communication methods to deliver services remotely; 3) expand prior authorization for automatic renewal of medications; 4) and adjust reimbursement rates for telehealth, COVID vaccine administration and provide supplemental payment for ICF/IDDs.
Approval Date: May 12, 2021
Effective Date: February 1, 2020
Topics: Benefits Disaster Relief Reimbursement