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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 5941 - 5950 of 15778

Connecticut
Updates the physician office and outpatient fee schedule by restructuring the payment methodology for pediatric medical providers who apply fluoride varnish to the teeth of Medicaid members and expands the age range of individuals who can receive an oral assessment and/or application of fluoride varnish by a pediatric medical provider.
 
Approval Date: February 10, 2020
Effective Date: July 1, 2019
Topics: Financing & Reimbursement

Colorado
Reimbursement update for School Health Services
Approval Date: February 9, 2020
Effective Date: October 1, 2020
Topics: Financing & Reimbursement

Vermont
SUPPORT Act Drug Utilization Review
Approval Date: February 7, 2020
Effective Date: October 1, 2019

Maine

This SPA allows the state to comply with the Medicaid Drug Utilization Review (DUR) provisions
included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery
and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271).

Approval Date: February 6, 2020
Effective Date: October 1, 2019
Topics: State Drug Utilization Data

Arizona
Proposes to allow the state to comply with the Medicaid Drug Utilization review (DUR) provisions included in 1004 of the SUPPORT for Patients and Communities Act with the effective date of October 1, 2019.
Approval Date: February 6, 2020
Effective Date: October 1, 2019

Maryland
Includes new drug review and utilization requirements set forth in section 1902(oo) of the Act. Specifically, Maryland is updating language to identify claim review limitations on safety edits and retrospective reviews, programs to monitor antipsychotic medications to children and fraud and abuse identification requirements
Approval Date: February 6, 2020
Effective Date: October 1, 2019

Ohio
Proposes to allow the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act 
Approval Date: February 6, 2020
Effective Date: October 1, 2019

Delaware
Proposes to amend the Title XIX Medicaid State Plan regarding DUR provisions included in section 1004 of the SUPPORT for Patients and Communities Act with the effective date of October 1, 2019.
Approval Date: February 6, 2020
Effective Date: October 1, 2019

New York
Proposes updates in State Plan Pages based on provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271).
 
Approval Date: February 6, 2020
Effective Date: October 1, 2019
Topics: Current State Plan Prescription Drugs

Maine
Proposes to allow the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act
Approval Date: February 6, 2020
Effective Date: October 1, 2019
Topics: Current State Plan Prescription Drugs