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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 6051 - 6060 of 15780

New York
APG updates to Hospital Outpatient (FMAP=50%)
Approval Date: December 19, 2019
Effective Date: July 1, 2019
Topics: Financing & Reimbursement

Oklahoma
Proposes to increase the nursing facility pool amounts, base rate components for nursing facilities serving adults and AIDS patients.
Approval Date: December 19, 2019
Effective Date: July 1, 2019
Topics: Financing & Reimbursement

Montana
Proposes to allow the Division of Medicaid 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). This amendment also proposes to allow the Division of Medicaid to comply with the requirements outlined in Montana House Bill 86 regarding a 7-day supply limit for opioid naïve members
Approval Date: December 18, 2019
Effective Date: October 1, 2019
Topics: Current State Plan Prescription Drugs

Georgia
Proposes to make Graduate Medical Education (GME) paid claims Add-On Payments for Community Service Boards (CSBs) with GME programs that are accredited by the Accreditation Council for Graduate Medical Education (ACGME). 
Approval Date: December 18, 2019
Effective Date: July 1, 2019
Topics: Current State Plan Program Administration

Kentucky
This amendment designates Stephanie M. Bates, Acting Commissioner of the KY Department for Medicaid Services, as the Governor’s designee for review and approval of state plan amendments
Approval Date: December 18, 2019
Effective Date: December 11, 2019
Topics: Current State Plan Program Administration

Ohio
Recovery Audit Contractor Exception 2020
 
Approval Date: December 18, 2019
Effective Date: January 1, 2020
Topics: Current State Plan Program Administration

Iowa

Increases available services to members on the basic benefit package. In particular, denture related services were added. During the SFY19 it was revealed that members with dentures in the basic benefit tier did not have access to the needed services.

Approval Date: December 18, 2019
Effective Date: August 30, 2019

Minnesota

This amendment to the MInnesota Medicaid state plan:

  • Reduces the rate to reflect the change in the MinnesotaCare provider tax on January 1,2020.
  • Adds a policy adjustment factor for specialty mental health services, and revises the policy adjustment factor for: burns; pre-major diagnostic category; transplants; and trauma.
  • Revises the charge limit.
  • Revises the base year to 2016 for hospital costs.
Approval Date: December 18, 2019
Effective Date: July 1, 2019
Topics: Program Administration

Wisconsin
Amends methods of Implementation for Nursing Home Payment Rates
Approval Date: December 18, 2019
Effective Date: July 1, 2019
Topics: Program Administration

Minnesota
Revises methodologies and standards for Inpatient Hospital rates. Specifically, this amendment:
. Reduces the rate to reflect the change in the MinnesotaCare provider tax on January 1,2020.
. Adds a policy adjustment factor for specialty mental health services, and revises the policy adjustment factor for: burns; pre-major diagnostic category; transplants; and trauma.
. Revises the charge limit.
. Revises the base year to 2016 for hospital costs.
Approval Date: December 18, 2019
Effective Date: July 1, 2019
Topics: Financing & Reimbursement