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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 3361 - 3370 of 15690

Massachusetts
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to update rates for vaccine and monoclonal antibody administration, vaccines administered by certain types of clinicians, and certain acute inpatient hospital and psychiatric inpatient hospital supplemental payments.
Approval Date: July 19, 2022
Effective Date: November 1, 2020
Topics: Disaster Relief Reimbursement

Maine
This plan amendment sets the rate for optometry, chiropractic, and podiatry services supplies at the lower of provider charges or 72.4% of the current Maine Medicare rate and by fee schedule for such se1vices not covered by Medicare.
Approval Date: July 19, 2022
Effective Date: July 1, 2022

Washington
This SPA specifies that audio-only telemedicine services do not receive facility fees for originating or distant sites.
Approval Date: July 19, 2022
Effective Date: July 1, 2022

North Dakota
This amendment updated the reimbursement methodology for nursing facility (NF) services.
Approval Date: July 19, 2022
Effective Date: January 1, 2022

Montana
updates the reimbursement methodology for psychiatric residential treatment facility (PRTF) services for State Fiscal Year 2023.
Approval Date: July 19, 2022
Effective Date: July 1, 2022

Pennsylvania
Continues the funding of multiple classes of inpatient disproportionate share hospital (DSH) payments and an
additional class of supplemental payments to Medical Assistance enrolled, qualifying inpatient acute care general hospitals.
Approval Date: July 19, 2022
Effective Date: May 9, 2022

California
This amendment extends the Non-Designated Public Hospital Supplemental Fund program for the state fiscal year ending 2023.
Approval Date: July 19, 2022
Effective Date: July 1, 2022

South Dakota
This amendment extends the supplemental payments for qualifying, private hospitals and nursing facilities for an additional state fiscal year.
Approval Date: July 19, 2022
Effective Date: May 1, 2022

New York
Updates the Ambulatory Patient Group (APG) for freestanding clinics.
Approval Date: July 18, 2022
Effective Date: July 1, 2022
Topics: Financing & Reimbursement

Colorado
Updates the reimbursement methodology for the state’s Hospital Back-Up Program. Specifically, rate setting will be based on the level of care needs of members, prospectively.
Approval Date: July 18, 2022
Effective Date: October 1, 2021