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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 5621 - 5630 of 15778

Utah
Updated the utilization trend for the outpatient hospital Upper Payment Limit (UPL) in state fiscal year (SFY) 2021
Approval Date: May 26, 2020
Effective Date: July 1, 2020
Topics: Current State Plan Financing & Reimbursement

Nevada
This amendment is to update the needs-based criteria; update who can perform evaluations and re-evaluations of 1915(i) eligibility; update language related to the CMS HCBS settings requirements; update who can perform the person-centered planning assessment; revise services covered under Habilitation services; and update reimbursement pages.
Approval Date: May 22, 2020
Effective Date: March 1, 2020
Topics: Benefits Eligibility Financing & Reimbursement Program Administration

Tennessee
Proposes to authorize the state to transfer all of the drugs on the Prescriber Attestation List to the Automatic Exemption List
Approval Date: May 22, 2020
Effective Date: March 1, 2020

Connecticut
Revises the Medical Clinic, Family Planning Clinic, Behavioral Health Clinic, Rehabilitation Clinic, and Ambulatory Surgical Center fee schedules
Approval Date: May 22, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Connecticut
Incorporates various 2020 Healthcare Common Procedure Coding System (HCPCS) updates (additions, deletions and description changes) to the Physician Office & Outpatient, Physician-Radiology, Physician-Surgery, and Psychology fee schedules. In addition, there are updates to the reimbursement methodology for specified drugs in order to comply with the approved Medicaid State Plan methodology for physician-administered drugs
Approval Date: May 22, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement Prescription Drugs

Minnesota
Adds income and resource disregards to certain individuals eligible for home and community-based waiver services under Section 1915c of the Social Security Act..
Approval Date: May 22, 2020
Effective Date: October 1, 2019

Connecticut
Incorporates the 2020 Healthcare Common Procedure Coding System (HCPCS) changes (additions, deletions and description changes) to the Independent Radiology and Independent Laboratory fee schedules
Approval Date: May 22, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Arizona
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to approve certain interim payments to hospitals, to make technical corrections to a previously-approved benefit adjustment, and to clarify the effective date for the previously-approved new optional eligibility group.
Approval Date: May 22, 2020
Effective Date: March 1, 2020
Topics: Disaster Relief Eligibility Financing & Reimbursement

Minnesota
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to adopt the following less restrictive income methodologies: Disregard from income, any payment made by a state, local or tribal government to relieve the adverse economic impacts of the COVID-19 pandemic for certain eligibility groups, and Disregard from assets the payments of a state, local or tribal government to relieve the adverse economic impacts of the COVID-19 pandemic that are retained following the month of receipt during the disaster period, and/or retained following the disaster period for certain eligibility groups.
Approval Date: May 22, 2020
Effective Date: March 13, 2020
Topics: Disaster Relief Eligibility

New Hampshire
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing and to allow hospitals to make presumptive eligibility determinations for this population.
Approval Date: May 22, 2020
Effective Date: March 18, 2020
Topics: Disaster Relief Eligibility