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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 5851 - 5860 of 15783

Utah
Updates the reimbursement for outpatient hospital dialysis to the same rate as the Medicare End Stage Renal Disease (ESRD) Prospective Payment System (PPS) Base Rate after the initial outpatient hospital encounter
Approval Date: March 10, 2020
Effective Date: January 13, 2020
Topics: Financing & Reimbursement

North Carolina

Revises North Carolina’s End State Renal Disease (ESRD) program’s policies and titles to expand dialysis to patients diagnosed with Acute Kidney Injuries (AKI).

Approval Date: March 10, 2020
Effective Date: January 1, 2020

Massachusetts
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: March 10, 2020
Effective Date: October 1, 2019

Nevada
Consolidates the supervision of the Peer Supporter under the Clinical Supervisor with the Behavioral Health Community Network (BHCN) and removes the requirement of medical supervision for the provider
Approval Date: March 10, 2020
Effective Date: January 1, 2020
Topics: Current State Plan Program Administration

Ohio
Proposes changes to coverage and limitations for dental services to reflect changes in the practice of dentistry, and updates payment rates
Approval Date: March 10, 2020
Effective Date: January 1, 2020
Topics: Benefits Eligibility Financing & Reimbursement

South Dakota
Clarifies that census bureau wages for temporary employment Goals and Objectives related to decennial census activities are not considered countable income.
Approval Date: March 10, 2020
Effective Date: January 13, 2020
Topics: Financing & Reimbursement Program Administration

Illinois
Proposes a $60 increase to the LTAC base per diem rate
Approval Date: March 9, 2020
Effective Date: January 1, 2020

Connecticut
Proposes to update the payment rates for nursing facility residents to provide for reimbursement when a resident of a Disaster Struck Nursing Facility must be temporarily evacuated to another facility due to a disaster for a period of up to thirty (30) days.
Approval Date: March 9, 2020
Effective Date: November 1, 2019
Topics: Financing & Reimbursement

Ohio
This SPA proposes increases to the Medicaid maximum payment amounts for transportation services in accordance with recent state legislation
Approval Date: March 9, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Alabama
Proposes to apply the reimbursement methodology for inpatient and outpatient hospital services for State fiscal year 2020 in a manner consistent with that used in fiscal year 2019
Approval Date: March 9, 2020
Effective Date: October 1, 2019
Topics: Financing & Reimbursement