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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 5991 - 6000 of 15862

Kansas
Proposes to allow the state to comply with the Medicaid Drug Utilization Review (DUR)
provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes
Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271).
Approval Date: February 24, 2020
Effective Date: October 1, 2019
Topics: Prescription Drugs Program Administration

Kansas
Allows the state to comply with the Medicaid Drug Utilization Review (DUR)
provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes
Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271).
Approval Date: February 24, 2020
Effective Date: December 2, 2019

Louisiana
Requests to amend the provisions governing the public process for managed care organizations (MCOs) by removing language that refers to the utilization of rulemaking to satisfy public comment requirements. The amendment also adds language to require a 30-day public comment period for MCO contract amendments and a 45-day public comment period for policy or procedure changes (unless the Louisiana Department of Health finds that imminent peril to the public's health, safety, or welfare requires immediate approval).
Approval Date: February 24, 2020
Effective Date: January 1, 2020

South Carolina
Updates SC DSH program as well as inpatient hospital payments
Approval Date: February 24, 2020
Effective Date: January 1, 2020

Montana
The state changes cost sharing (deductibles, co-insurance or co-payments) to individuals covered under Medicaid.
Approval Date: February 24, 2020
Effective Date: January 1, 2020

California
Medi-Cal reimbursement rates for Durable Medical Equipment
Approval Date: February 24, 2020
Effective Date: January 1, 2019

California
Drug Utilization Review, SUPPORT Act compliance
Approval Date: February 21, 2020
Effective Date: October 1, 2019

Oklahoma
Removes monthly prescription limit for drugs that require frequent monitoring. In addition, it increase prescription quantity for drugs within the maintenance drug list from 100 dosage units to a 90-day supply per claim
Approval Date: February 21, 2020
Effective Date: January 1, 2020

Minnesota
Reasonable classification of children under age 21 in state funded foster care.
Approval Date: February 21, 2020
Effective Date: April 1, 2020

Delaware
Adds facilities to which originating site fees can be paid, specifically Federally Qualified Health Centers and School Based Wellness Centers, for telemedicine services
Approval Date: February 19, 2020
Effective Date: January 1, 2020
Topics: Benefits Financing & Reimbursement