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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 4711 - 4720 of 15690

Oklahoma
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 a temporary supplemental payment for long-term care facilities and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) to support increased costs due to COVID-19.
Approval Date: May 12, 2021
Effective Date: July 1, 2020
Topics: Disaster Relief Reimbursement

Washington
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 provide an add-on payment to nursing facilities throughout the duration of the public health emergency.
Approval Date: May 12, 2021
Effective Date: August 1, 2020
Topics: Disaster Relief Reimbursement

Guam
Effective January 1, 2021, this amendment increases the local poverty level (LPL) such that the MAGI income standards of 138% of the LPL is equivalent to 150 percent of the federal poverty level (FPL). 
Approval Date: May 12, 2021
Effective Date: January 1, 2021
Topics: Eligibility Financing & Reimbursement Program Administration

Maryland
The categories of providers allowed to order home health services benefit were initially authorized through Disaster Relief SPA DR SPA 20-0003 effective March 1, 2020.
Approval Date: May 12, 2021
Effective Date: January 1, 2021

Delaware
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 provide a reimbursement methodology for Medicaid vaccine administration fees and pharmacy dispensing fees for the COVID-19 vaccine.
Approval Date: May 11, 2021
Effective Date: December 1, 2020
Topics: Benefits Disaster Relief Reimbursement

Wisconsin
Effective January 1, 2021, this amendment updates the maximum amount allowed for the maintenance of a home for beneficiaries living in an institution to follow the Social Security Cost of living adjustment. 
Approval Date: May 11, 2021
Effective Date: January 1, 2021
Topics: Benefits Financing & Reimbursement Program Administration

Pennsylvania
Update to include provision of targeted support management for individuals age 0 through 8 with a developmental disability and individuals age 0 through 21 with a medically complex condition who have been determined eligible for an ICF/ORC level of care and are eligible for Medical Assistance under the State Plan.
Approval Date: May 11, 2021
Effective Date: July 1, 2021
Topics: Program Administration

Ohio
Effective May 1, 2021, this amendment provides approval for Third Party Liability (TPL): Blanket good cause exception for children in state custody; 100-day timeline for billing non-responsive third parties. 
Approval Date: May 10, 2021
Effective Date: May 1, 2021
Topics: Financing & Reimbursement

New Mexico
Effective March 1, 2021, this amendment implements a new reimbursement methodology for all Indian Health Services and Tribal 638 pharmacy facilities based on the All-Inclusive Rate (AIR). 
Approval Date: May 10, 2021
Effective Date: March 1, 2021

Hawaii
creates a new eligibility group. This group, also identified under the “Ticket to Work and Work Incentives Improvement Act” authority, allows individuals with a disability at least 19 years of age but less than 65 years of age whose income is below 138% of the Federal Poverty Level and applicable Household size a resource standard equal to three (3) times the SSI resource limit adjusted annually by the increase in the consumer price index to qualify and or keep their Medicaid coverage.
Approval Date: May 10, 2021
Effective Date: January 1, 2021