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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 5611 - 5620 of 15778

Connecticut
Incorporates various 2020 Healthcare Common Procedure Coding System (HCPCS) changes (additions, deletions and description changes). Codes that are being added are being priced using a comparable methodology to other codes in the same or similar category and replacement codes are being priced in a manner designed to make the billing code updates cost-neutral.  
Approval Date: May 28, 2020
Effective Date: January 1, 2020
Topics: Adjustment Codes Program Administration

South Dakota
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to waive cost-sharing for testing services, testing-related services and treatments of COVID-19 and suspend the face-to-face requirements for community mental health centers.
Approval Date: May 28, 2020
Effective Date: March 1, 2020
Topics: Benefits Cost Sharing Disaster Relief Eligibility

Connecticut
This plan amendment incorporates the 2020 Healthcare Common Procedure Coding System (HCPCS) changes (additions, deletions and description changes) to the Independent Therapy fee schedule. Codes that
are being added are being priced using a comparable methodology to other codes in the same or similar category. These changes are being made to ensure this fee schedule remains compliant with the Health
Insurance Portability and Accountability Act (HIPAA).
Approval Date: May 28, 2020
Effective Date: January 1, 2020
Topics: Benefits Program Administration

Nebraska
Updates the rates for Licensed Practical Nursing (LPN) private duty nursing services provided by a home health agency and adds more comprehensive language describing the reimbursement methodology for Extended Home Health Services.
Approval Date: May 28, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Utah
Quality improvement incentives
Approval Date: May 28, 2020
Effective Date: April 1, 2020

Delaware
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to suspend all copayments and premiums for all beneficiaries, modify telehealth benefits and allow payment accordingly, adjust the day supply or quantity limit for covered outpatient drugs, expand Prior authorization for medications automatic renewal without clinical review, or time/quantity extensions, and make exceptions to their published Preferred Drug List if drug shortages occur.
Approval Date: May 27, 2020
Effective Date: March 1, 2020
Topics: Benefits Cost Sharing Disaster Relief Financing & Reimbursement Premiums Prescription Drugs

Virginia
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to consider individuals who are evacuated or absent from the state due to the disaster or public health emergency and who intend to return to the state, to continue to be residents of the state. The amendment makes adjustments to the day supply and quantity limit for covered outpatient medications and will make exceptions to their published Preferred Drug List if drug shortages occur. In addition, the amendment increases payment rates for nursing facilities, specialized care providers, and updates the dental fee schedule.
Approval Date: May 27, 2020
Effective Date: March 12, 2020
Topics: Benefits Disaster Relief Eligibility Financing & Reimbursement Prescription Drugs

Alabama
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to provide a 20% increase in per diem rates for all COVID-19 diagnosis patients for hospital inpatient stays due to increases in cost associated with staffing, supplies, social distancing standards and other factors.
Approval Date: May 27, 2020
Effective Date: March 1, 2020
Topics: Disaster Relief Financing & Reimbursement

Louisiana
Amends the provisions governing the definition of a public, non-rural community hospital, to include Thibodaux Regional Medical Center, formerly owned by a parish, city or other local government or instrumentality, after January 1, 2019.
Approval Date: May 27, 2020
Effective Date: January 1, 2020

New York
Proposes to update the rate methodology for private intermediate care facilities
Approval Date: May 26, 2020
Effective Date: July 1, 2014
Topics: Financing & Reimbursement