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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 3611 - 3620 of 15693

District of Columbia
To add coverage to the District of Columbia’s Alternative Benefit Plan Medicaid Expansion, Routine Patient Cost in Qualifying Clinical Trials.
Approval Date: May 5, 2022
Effective Date: January 1, 2022

Maine
This plan amendment establishes the rate for ostomy supplies at the lower of provider charges or 88.2% of the current Maine Medicare rate.
Approval Date: May 4, 2022
Effective Date: March 1, 2022
Topics: Financing & Reimbursement

Mississippi
Complies with necessary changes resulting from the Consolidated Appropriations Act, 2021 requiring mandatory coverage of routine patient costs for services furnished in connection with participation by Medicaid beneficiaries in qualifying clinical trials on or after January 1, 2022.
Approval Date: May 4, 2022
Effective Date: January 1, 2022

New York
Increases medical assistance rates of payment for diagnostic and treatment center services to New York City Health and Hospitals Corporation and county operated DTCs and mental hygiene clinics.
Approval Date: May 4, 2022
Effective Date: April 1, 2022
Topics: Program Administration

South Carolina
Increase rates for certain incontinence supplies, Substance Abuse and Addictive Disorder
services, autism spectrum disorder (ASD) services, and peer support services.
Approval Date: May 4, 2022
Effective Date: January 1, 2022
Topics: Medical Supplies & Devices

Connecticut
Allows reimbursement changes for private intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs). Specifically, this SPA provides specified fair rent increases and implements a rate increase of 4.3% to pay for costs of wage and benefit enhancements.
Approval Date: May 4, 2022
Effective Date: July 1, 2022
Topics: Financing & Reimbursement

California
This SPA amends the Alternative Benefit Plan (ABP) to restore comprehensive adult optional dental benefits, subject to medical necessity and utilization controls, for eligible adults. This SPA aligns the ABP with the restoration of adult optional dental benefits in the State Plan under the approval of SPA 17-0027.
Approval Date: May 3, 2022
Effective Date: January 1, 2018
Topics: Alternative Benefit Plan

Texas
This SPA amends to implement changes to state law meant to further the use of telemedicine and telehealth by allowing the option to receive certain services using an audio-only platform.
Approval Date: May 3, 2022
Effective Date: February 1, 2022

Oklahoma
This amendment updates the frequency of Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) dental oral prophylaxis services from eve1y 184 days to eve1y six months.
Approval Date: May 3, 2022
Effective Date: September 1, 2022

Arkansas
This amendment proposes allows pharmacists to enroll individually as atypical providers to prescribe and administer specified drugs, and test and screen for certain health conditions.
Approval Date: May 3, 2022
Effective Date: June 1, 2022