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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 5331 - 5340 of 15689

Oklahoma
increase the number of covered inpatient rehabilitation hospital days for adult SoonerCare members from 24 days per state fiscal year to 90 days per state fiscal year
Approval Date: August 14, 2020
Effective Date: September 1, 2020
Topics: Current State Plan Eligibility Program Administration

Michigan
Proposed to establish a single preferred drug list  (PDL) for Michigan Medicaid Pharmacy Coverage
Approval Date: August 14, 2020
Effective Date: October 1, 2020

North Dakota
Amends the State Plan to update the Standards for the Coverage of Organ Transplant Services
Approval Date: August 14, 2020
Effective Date: July 1, 2020

West Virginia
Updates the effective date of the fee schedules for dental, orthodontic and oral and maxillofacial Services.
Approval Date: August 13, 2020
Effective Date: April 1, 2020
Topics: Dental Program Administration

Connecticut
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing, expand coverage to certain 1915, 1915(k), home health, laboratory and telehealth services, adjust prior authorizations for medications, and increase certain payment rates.
Approval Date: August 13, 2020
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief Prescription Drugs Reimbursement

West Virginia
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 changes to eligibility, suspend most cost-sharing, adjust some existing benefits, expand telehealth flexibilities, and make certain payment changes.
Approval Date: August 13, 2020
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief Eligibility Reimbursement

Colorado
Changes from paying licensed pharmacists individually for Medication Therapy Counseling to contracting with an entity to run the program, and updates program requirements and restrictions.
Approval Date: August 12, 2020
Effective Date: August 1, 2020
Topics: Program Administration

South Dakota
Provides separate reimbursement of high cost prescription drugs outside of the IHS/Tribal encounter rate
Approval Date: August 11, 2020
Effective Date: April 1, 2020
Topics: Prescription Drugs Reimbursement

Nevada

Updates to add a new §1915(i) Home and Community-based Services (HCBS) benefit.

Approval Date: August 11, 2020
Effective Date: July 1, 2020

Arkansas
increases access to medications for Arkansas Medicaid members with opioid use disorder and removes prior authorization requirements for Medication Assisted Treatment
Approval Date: August 11, 2020
Effective Date: August 1, 2020
Topics: Prescribed Drugs Program Administration