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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 4941 - 4950 of 15693

California
Establishes the Tribal Federally Qualified Health Centers (FQHC) provider type in Medi-Cal and establishes an Alternative Payment Methodology (APM) at the Indian Health Services All-Inclusive Rate for Tribal FQHCs 
Approval Date: February 19, 2021
Effective Date: January 1, 2021
Topics: Indian Health Services

New Jersey
Proposes to add coverage allowing Doula Services to provide support for pregnant individuals throughout the perinatal period to the Title XIX and State Plan
Approval Date: February 19, 2021
Effective Date: January 1, 2021

Indiana
Proposes to make technical changes to the template utilized in administering the state's supplemental drug rebate program
Approval Date: February 17, 2021
Effective Date: October 1, 2020

Louisiana
The Louisiana Department of Health, Bureau of Health Services Financing proposes to amend the provisions governing the reimbursement methodology for nursing facilities in order to increase the allowable square footage for calculating payments when a Medicaid participating nursing facility has at least 15 percent of its licensed beds in private rooms
Approval Date: February 17, 2021
Effective Date: December 20, 2020
Topics: Financing & Reimbursement

Alaska
Updates the plan to expand coverage and reimbursement for vaccine administration in accordance with authorizations provided under the Public Readiness and Emergency Preparedness (PREP) Act declaration.    Further, it clarifies the reimbursement methodology for medically necessary vaccines products; expands the list of practitioners able to order Home Health services; clarifies the administrative vaccine rate for children eligible under the Vaccine for Children (VFC) Program; and, incorporates reimbursement for administration of vaccinations to the adult population.  
Approval Date: February 17, 2021
Effective Date: October 1, 2020
Topics: Financing & Reimbursement Vaccine - Policy Clarification

Massachusetts
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purposes of this amendment is to update Payment Methodologies for Certain Hospital, Community Health Centers, Physician, and coverage for mobile testing service done by EMTs during the COVID-19 Emergency period.
Approval Date: February 12, 2021
Effective Date: March 1, 2020
Topics: Coverage Disaster Relief Financing & Reimbursement

Minnesota
This SPA revises state plan language to modify the requirements for delivery of case management services
Approval Date: February 12, 2021
Effective Date: October 1, 2021

Iowa
Proposes to allow Physician Assistants to bill independently from the supervising physician. The SPA also establishes a rate payment for Physicians Assistants
Approval Date: February 11, 2021
Effective Date: December 1, 2020
Topics: Financing & Reimbursement

Washington
Implements a resource disregard of earnings accumulated in a separate account during an individual's enrollment in a working disability eligibility group when determining the individual's subsequent eligibility for other eligibility groups covered under Washington’s state plan
Approval Date: February 10, 2021
Effective Date: April 1, 2020

Oklahoma
Requires the use of an Electronic Visit Verification (EVV) system for personal care services (PCS) that require and in-home visit
by a provider.
Approval Date: February 4, 2021
Effective Date: January 1, 2021
Topics: Program Administration