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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 3661 - 3670 of 15692

California
Exempts Durable Medical Equipment (DME) Complex Rehabilitation Technology (CRT) and Complex Rehabilitation Technology Services (CRTS) from the ten percent payment reductions.
Approval Date: April 21, 2022
Effective Date: January 1, 2022
Topics: Financing & Reimbursement

Ohio
Payment for Services: Non-Institutional Payment Schedule, Behavioral Health E&M codes Updates for 2022.
Approval Date: April 21, 2022
Effective Date: January 1, 2022
Topics: Financing & Reimbursement

Maine
SPA was submitted in order to implement Maine’s Primary Care Plus (PCPlus) Program, intended to replace the three existing primary care programs in the state with a single simplified and integrated program.
Approval Date: April 21, 2022
Effective Date: July 1, 2022

Louisiana
This SPA amended the provisions governing Rural Health Clinics (RHCs) in order to establish that where payment(s) from managed care organizations (MCOs) are less than the amount the RHC would be entitled to receive under the Prospective Payment System (PPS) or alternative payment methodology (APM), the RHC will be eligible to receive a wrap-around supplemental payment processed and paid by the Louisiana Department of Health.
Approval Date: April 21, 2022
Effective Date: January 27, 2022

South Dakota
The SPA provides assurances that the State complies with federal requirements regarding coverage of routine patient care associated with participation in clinical trials as required by the Consolidated Appropriations Act, 2021.
Approval Date: April 20, 2022
Effective Date: January 1, 2022

Missouri
This State Plan Amendment outlines the processes that the State will implement to assure that the Urban Indian Organization(s) has (have) opportunities to review any future changes to the Medicaid State Plan prior to implementation.
Approval Date: April 19, 2022
Effective Date: April 1, 2022
Topics: Tribal/Indian Health Services

Pennsylvania
Authorizes supplemental payments to qualifying non-public nursing facilities in a county of the eighth class.
Approval Date: April 19, 2022
Effective Date: January 9, 2022
Topics: Financing & Reimbursement

Wisconsin
This amendment will modifies Wisconsin's RUGs and PDPM reimbursement methodology to nursing homes.
Approval Date: April 19, 2022
Effective Date: July 1, 2022

Georgia
This SPA proposes to add provisions which will allow the coverage of routine patient costs furnished in connection with participation with qualifying clinical trials
Approval Date: April 15, 2022
Effective Date: January 1, 2022

Maryland
To update the State Plan language to comply with the amended section 1905(a)(30) of the Social Security Act, assuring coverage to eligible Medicaid participants for routine patient costs for otherwise covered items and services resulting from a qualifying clinical trial.
Approval Date: April 15, 2022
Effective Date: January 1, 2022