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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 3301 - 3310 of 15689

Maine
Adding CPT code 96125 to OT benefit effective 11/1/2021
Approval Date: August 12, 2022
Effective Date: November 1, 2021
Topics: Financing & Reimbursement

Georgia
This amendment proposes to implement Express Lane Eligibility (ELE).
Approval Date: August 11, 2022
Effective Date: October 1, 2022

Maine
updates fee schedule rates for Physical Therapy and Occupational Therapy services
Approval Date: August 11, 2022
Effective Date: April 1, 2017
Topics: Financing & Reimbursement

Montana
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to implement an incremental increase to the current Urban Indian Organization (UIO) Prospective Payment System (PPS) rates effective July 1, 2021, through the duration of the Public Health Emergency (PHE).
Approval Date: August 10, 2022
Effective Date: July 1, 2021
Topics: Disaster Relief Reimbursement

Maine
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to revise the previously approved date for payment of retention bonuses to direct support workers pursuant to the American Rescue Plan Act (ARP) of 2021, Section 9817 (Pub. L. 117-2). Payment by agencies to staff must occur between July 1, 2021 and December 31, 2022.
Approval Date: August 10, 2022
Effective Date: April 1, 2021
Topics: Disaster Relief Reimbursement

California
This amendment is to add asthma preventive services as a preventive service.
Approval Date: August 10, 2022
Effective Date: July 1, 2022
Topics: Coverage and Reimbursement

Illinois
provides for a rate increase for Early Intervention Services.
Approval Date: August 10, 2022
Effective Date: July 1, 2022

Utah
updates Outpatient Hospital Supplemental Payments
Approval Date: August 10, 2022
Effective Date: July 1, 2022
Topics: Financing & Reimbursement

California
This amendment changes to the Preadmission Screening and Resident Review (PASRR) program procedures as follows: include and reinforce the conditions of the Exempted Hospital Discharge option for hospitals; change the term “severe mental illness” to “serious mental illness;” and remove the categorical options Convalescent Care, 5150 and 5250 in the PASRR Level I Screening process.
Approval Date: August 8, 2022
Effective Date: July 1, 2022
Topics: Program Administration

Utah
updates pricing for medical supplies and DME
Approval Date: August 8, 2022
Effective Date: July 1, 2022