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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 4971 - 4980 of 15820

Texas
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to allow licensed practitioners practicing within their scope of practice, such as nurse practitioners and physician assistants, to order Medicaid home health services during the COVID-19 pandemic.
Approval Date: March 25, 2021
Effective Date: March 18, 2021
Topics: Benefits Disaster Relief

Virgin Islands
 This amendment proposes adding coverage and payment methodology of Personal Care Attendant Services (PCAP) in the U.S. Virgin Islands Medicaid program, approved initially on March 25, 2021.  At the time of approval, the end of the PHE was not known.  Now that the date is known, this SPA has been updated to reflect an effective of May 12, 2023.
Approval Date: March 25, 2021
Effective Date: May 12, 2023
Topics: Coverage Financing & Reimbursement

Montana
This amendment modifies the state’s paper and online applications to integrate eligibility for the state’s 1115 family planning demonstration waiver into the state’s Medicaid eligibility application and eligibility determination system. The changes are limited to inclusion of two additional questions to ensure an applicant can apply and be determined eligible for family planning coverage, as provided under Montana’s section 1115 family planning demonstration.
Approval Date: March 25, 2021
Effective Date: March 25, 2021
Topics: Eligibility Program Administration

Louisiana
The amendment is to comply with the Louisiana regulations related to transfer of assets in the Medicaid assistance program.
Approval Date: March 25, 2021
Effective Date: October 1, 2020
Topics: Program Administration

Rhode Island
The purpose of this amendment is to add a cost-based reimbursement methodology for state-owned inpatient hospital services. 
Approval Date: March 25, 2021
Effective Date: April 1, 2020
Topics: Financing & Reimbursement

Iowa
Effective January 1, 2021, this amendment rebases the rate for Outpatient Hospital Services for acute care hospitals using cost reports ending in calendar year 2019.
Approval Date: March 24, 2021
Effective Date: January 1, 2021
Topics: Financing & Reimbursement

Nebraska
Effective September 1, 2020, this amendment provides targeted rate increases for providers of mental health and behavioral health services, specifically individual psychotherapy, substance use assessment, and day rehabilitation services. 
Approval Date: March 24, 2021
Effective Date: September 1, 2020
Topics: Financing & Reimbursement

New Jersey
Effective October 1, 2020 through June 30, 2021, this amendment authorizes a ten percent increasing adjustment to reimbursement rates for Class I, Class II, and Class III nursing facilities. 
Approval Date: March 24, 2021
Effective Date: October 1, 2020
Topics: Financing & Reimbursement

Oklahoma
Effective May 1, 20201, this amendment replaces certified diabetes educator requirements with more pertinent training/experience for existing providers of diabetes self-management education and support services(DSMES). Additionally, the amendment adds licensed health care professionals who hold a board certification in advanced diabetes management are certified diabetes care and education specialists, or are under the supervision of a licensed practitioner within state scope of practice as a provider of DSMES services. 
Approval Date: March 24, 2021
Effective Date: May 1, 2021
Topics: Program Administration

Oregon
Effective February 1, 2021, this amends the current targeted case management state plan amendment for public health nurse home visiting to include three additional counties (Baker, Clatsop and Marion).
Approval Date: March 24, 2021
Effective Date: February 1, 2021
Topics: Financing & Reimbursement Program Administration