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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 3621 - 3630 of 15690

Washington
Updates references to the 3M APR-DRG software grouper used to group hospital claims for payment.
Approval Date: May 3, 2022
Effective Date: May 1, 2022

Illinois
This amendment implement Sections 1905(a)(30) and 1905(gg) of the Social Security Act, which require coverage of routine patient costs associated with participation in qualifying clinical trials.
Approval Date: May 2, 2022
Effective Date: January 1, 2022

Arkansas
This amendment establishes soft annual limits of $500 on radiology and diagnostic laboratory services, respectively.
Approval Date: May 2, 2022
Effective Date: July 1, 2022

District of Columbia
 To effectuate the coverage of routine patient costs incurred during qualified clinical trials from January 1, 2022 forward, as required by the Consolidated Appropriations Act, 2021, Division CC, Title II, Section 210.
Approval Date: May 2, 2022
Effective Date: January 1, 2022

Nevada
This SPA amendment is to allow coverage of routine patient costs furnished in connection with participation in a qualifying clinical trial.
Approval Date: May 2, 2022
Effective Date: January 1, 2022

California
This SPA modifies the definition of a Peer Support Specialist to be aligned with the Medi-Cal Peer Support Specialist Certification Program, which requires Peer Support Specialists to be in recovery themselves or have lived experience with the process of recovery as a parent, caregiver, or family member.
Approval Date: May 2, 2022
Effective Date: July 1, 2022

Florida
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to add an end date to previously approved emergency provisions due to the COVID-19 Public Health Emergency.
Approval Date: April 29, 2022
Effective Date: July 1, 2021
Topics: Disaster Relief Reimbursement

Hawaii
This SPA amends to increase the monthly income eligibility standards for Hawaii's optional state supplement program.
Approval Date: April 29, 2022
Effective Date: January 1, 2022

Minnesota
Physician payment rates.
Approval Date: April 29, 2022
Effective Date: February 1, 2022
Topics: Financing & Reimbursement

California
Adjusts rates for Radiological services so that they do not exceed 80% of the corresponding Medicare rate.
Approval Date: April 29, 2022
Effective Date: January 1, 2022