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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 751 - 760 of 15690

Wisconsin

This plan amendment proposes that Tribal Federally Qualified Health Centers (FQHCs) may choose reimbursement for Medicaid covered services under one of two options, 1. Prospective Payment System (PPS) Rate, or 2. OMB All Inclusive Rate (AIR). In addition, Tribal FQHC Pharmacy dispensed drugs will be reimbursed according to the 1905(a)(12) prescribed drug benefit under either option.

Approval Date: August 23, 2024
Effective Date: January 1, 2024

Georgia

This plan amendment updates the reimbursement rates for select Occupational Therapy codes, Physical Therapy codes, Speech Language Pathology codes and Audiology codes.

Approval Date: August 23, 2024
Effective Date: July 1, 2024

Georgia

This amendment proposes to allow licensed professional counselors, licensed marriage and family therapists, and certified peer specialists to deliver services and be reimbursed by Federally Qualified Health Centers according to the Practitioner's Practice Act.

Approval Date: August 22, 2024
Effective Date: April 1, 2024
Topics: Coverage Other Licensed Practitioners Preventive Services Reimbursement

Oklahoma

This amendment amend the Supplement to Attachment 4.22, which provides an attestation that state laws are in place that restrict third party insurers from denying a claim solely on the basis that the Medicaid member failed to obtain prior authorization for a service so long as that service is covered in the state plan or a waiver.

Approval Date: August 22, 2024
Effective Date: June 14, 2024

New Hampshire

This plan amendment authorizes the quarterly nursing home supplemental payment, also known as MQIP, for dates of service in the quarter ending June 30, 2024.

Approval Date: August 21, 2024
Effective Date: April 1, 2024

New York

This plan amendment reduces the capital component of the Medicaid rates for all residential health care facilities, excluding pediatric residential health care facilities, by 10%.

Approval Date: August 20, 2024
Effective Date: April 1, 2024

Ohio

Adds coverage for mental health peer support services to Ohio's Alternative Benefit to align with the Medicaid State Plan.

Approval Date: August 20, 2024
Effective Date: September 1, 2024
Topics: Alternative Benefit Plan

Colorado

The SPA provides coverage for doula services for Medicaid-enrolled pregnant and postpartum persons effective July 1, 2024.

Approval Date: August 19, 2024
Effective Date: July 1, 2024
Topics: Coverage and Reimbursement

Ohio

Removes Peer Recovery Services from the 1915(i) Specialized Recovery Services Program.

Approval Date: August 16, 2024
Effective Date: September 1, 2024
Topics: Home and community based services

Ohio

Adds coverage and payment provisions for mental health peer support services to the State Plan rehabilitation benefit.

Approval Date: August 16, 2024
Effective Date: September 1, 2024