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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 4911 - 4920 of 15820

New Mexico
Effective January 01, 2021, this amendment adds substance use disorder (SUD) as an additional eligibility criterion for Health Home Services. For payments made to Health Homes providers for Health Homes participants who newly qualify based on the Health Homes program’s additional condition coverage under this amendment, a medical assistance percentage (FMAP) rate of 90% applies to such payments for 8 quarters from the effective date of this SPA. The FMAP rate for payments made to health homes providers will return to the state's published FMAP rate at the end of the enhanced match period.
Approval Date: April 15, 2021
Effective Date: January 1, 2021
Topics: Current State Plan Eligibility Federal Financial Match Financing & Reimbursement Program Administration

Oklahoma
Effective July 1, 2021 this amendment removes the 24-day per state fiscal year limit for covered inpatient physician and surgical services provided to adult SoonerCare members to align with current practices and for the purposes of the alternative benefit plan (ABP) for adults in the expansion group. 
Approval Date: April 14, 2021
Effective Date: July 1, 2021
Topics: Program Administration

Pennsylvania
Effective October 1, 2020, this amendment updates the Outpatient Upper Payment Limit (UPL) Methodology.
Approval Date: April 14, 2021
Effective Date: October 1, 2020
Topics: Current State Plan Financing & Reimbursement Program Administration

Alabama
Increases the Current Asset Value for Nursing Facilities to account for the increased costs of Nursing Facilities and to provide parameters for the Quality Incentive Add-on Payment to Nursing Facilities.
Approval Date: April 13, 2021
Effective Date: October 1, 2020
Topics: Program Administration

Delaware
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to make an add-on per diem payment to a nursing facility that has a dedicated isolation unit for treatment of COVID (COVID Unit).
Approval Date: April 13, 2021
Effective Date: December 1, 2020
Topics: Disaster Relief Reimbursement

Kentucky
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to provide assistance to nursing facilities that have seen a decline in resident occupancy and do not meet the 75% reimbursement rate for bed reserve, instead of being paid at the 50% rate level, during the Public Health Emergency period.
Approval Date: April 13, 2021
Effective Date: April 1, 2020
Topics: Disaster Relief Reimbursement

Colorado
Effective January 01, 2021, this amendment allows for an increase to the pediatric personal care reimbursement rate for Denver-area providers.
Approval Date: April 13, 2021
Effective Date: January 1, 2021
Topics: Financing & Reimbursement

District of Columbia
This amendment continues a physician supplemental payment for fiscal year 2021
Approval Date: April 12, 2021
Effective Date: January 1, 2021
Topics: Financing & Reimbursement

Colorado
Effective October 1, 2020, this amendment creates the Minimum Wage Supplemental Payment for qualifying nursing facility providers, for services on or after the effective date. 
Approval Date: April 9, 2021
Effective Date: October 1, 2020
Topics: Financing & Reimbursement

Iowa
Effective ..... this amendment updates the methods and standards for the state-owned physician supplemental payment methodology. 
Approval Date: April 9, 2021
Effective Date: July 1, 2020
Topics: Allocation Methodologies Financing & Reimbursement