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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 5491 - 5500 of 15777

Nebraska
This state plan amendment establishes an Alternative Benefit Plan to serve persons eligible for Medicaid under Section 1902(a)(10)(A)(VIII) of the Social Security Act. This plan will offer Prime benefits equal to the current State Plan benefits offered in the state.
Approval Date: July 6, 2020
Effective Date: October 1, 2020
Topics: Benefits Dental Eligibility

Tennessee
Updates to the paper application, and the state’s election to use an alternative single, streamlined application developed by the state for individuals applying for coverage who may be eligible based on the applicable modified adjusted gross income standard
Approval Date: July 4, 2020
Effective Date: October 22, 2018

Utah
Updates the reimbursement methodology for capital improvement incentive payments
for intermediate care facilities for individuals with intellectual disabilities (ICF/IID).
Approval Date: July 2, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

North Dakota
Updates the state plan by extending the supplemental payment for critical access
hospitals (CAHs) for an additional two-year period
Approval Date: July 1, 2020
Effective Date: June 30, 2020
Topics: Current State Plan Financing & Reimbursement

Illinois
Changes to hospital inpatient and outpatient reimbursement 
Approval Date: July 1, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

New York
Revises the reimbursement method for acute inpatient hospital rates
Approval Date: July 1, 2020
Effective Date: July 1, 2014
Topics: Financing & Reimbursement

Utah
Updates the Durable Medical Equipment (DME) fee schedule.
Approval Date: July 1, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement Program Administration

Montana
This amendment updates the Other Rehabilitation Services benefit and reimbursement.
Approval Date: July 1, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

New York
Eliminates the Health Home per member per month (pmpm) “outreach” payment for all members (adults and children) in the case finding group from $75 pmpm to a rate of $0 pmpm.
Approval Date: June 30, 2020
Effective Date: July 1, 2020

Wisconsin
This time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to increase the cap for supplemental disproportionate hospital share (DHS) payments to qualifying hospital providers.
Approval Date: June 30, 2020
Effective Date: May 1, 2020
Topics: Disaster Relief Financing & Reimbursement