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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 5541 - 5550 of 15777

Nevada
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to add the COVID-19 testing group under 1902(a)(10)(A)(ii)(XXIII) of the Act; Allow individuals who are evacuated from the state, who leave the state for medical reasons related to the disaster or public health emergency, or who are otherwise absent from the state due to the disaster or public health emergency and who intend to return to the state continue to be residents of the state under 42 CFR 435.403(j)(3); Implement lab benefit flexibilities under 42 CFR 440.30(a) and 42 CFR 440.30(b); and Allow for 100 percent Medicaid reimbursement in accordance with Medicare reimbursement for COVID-19 laboratory testing procedure codes.
Approval Date: June 18, 2020
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief Eligibility Financing & Reimbursement

Oregon
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to designate Contracted Community Partner organizations as qualified entities to make presumptive eligibility determinations; consider individuals evacuated from the state due to the emergency to continue to be residents; allow flexibility for mobile testing for COVID-19; and waive medication supply limits when appropriate to reduce exposure risk. In addition, this amendment will allow for changes in reimbursement policies and adjustment of payment rates for certain services and providers.
Approval Date: June 18, 2020
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief Eligibility Financing & Reimbursement Prescription Drugs

Puerto Rico
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to disregard unemployment compensation benefits funded by the territory for the non-MAGI population
Approval Date: June 18, 2020
Effective Date: March 1, 2020
Topics: Disaster Relief Eligibility

New York
Applies a 1 % reduction uniformly across payments made under certain sections in the 4.19B section of the state plan.
Approval Date: June 17, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement Program Administration

Wyoming
Applies a census income disregard to the Medicare Savings Programs (MSPs) and to migrate eligibility requirements already approved for MSPs under the existing state plan.
Approval Date: June 17, 2020
Effective Date: April 1, 2020
Topics: Program Administration

Missouri
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow additional flexibilities for pharmacists; suspend Medicaid copayments for all items and services for all eligibility groups; allow flexibilities for home health and personal care benefits; make payment changes to personal care services; and provide flexibilities for personal care assessments, evaluations, training and person-centered care planning.
Approval Date: June 17, 2020
Effective Date: March 1, 2020
Topics: Benefits Cost Sharing Disaster Relief Financing & Reimbursement

Texas
Updates the clinical laboratory services page of the State Plan as a result of the 2020 calendar year fee review of clinical diagnostic laboratory services
Approval Date: June 17, 2020
Effective Date: January 1, 2020

Texas
Updates the clinical laboratory services page of the State Plan as a result of the 2020 calendar year fee review of clinical diagnostic laboratory services.
Approval Date: June 17, 2020
Effective Date: January 1, 2020

Alabama
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow code D1999 (Unspecified preventive procedure) to be billed and reimbursed at $20.00 to allow for reimbursement of PPE and cleaning supplies PPE that are necessary for dental offices to provide treatment to recipients.
Approval Date: June 16, 2020
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief Financing & Reimbursement

New Mexico
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to implement targeted access supplemental payments for Safety-Net Care Pool (SNCP) hospitals.
Approval Date: June 16, 2020
Effective Date: March 1, 2020
Topics: Disaster Relief Financing & Reimbursement