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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 5861 - 5870 of 15783

Washington
Affirms state compliance with sections 1902(a)(85), 1902(a)(83)(oo), and 1927(g) of the Social Security Act; updates Drug Utilization Review program information; affirms state fraud and abuse processes related to opioids; affirms MCO requirements to participate in SUPPORT Act-mandated actions; and updates language to align with language in the Social Security Act and CFR
Approval Date: March 6, 2020
Effective Date: October 1, 2019

Maine
Proposes reimbursement to hospitals other than critical access hospitals for each day after the tenth (10th) day that an eligible individual is in the care of the hospital while awaiting placement in a nursing facility
Approval Date: March 6, 2020
Effective Date: October 1, 2019
Topics: Eligibility Financing & Reimbursement

Michigan
Clarifies coverage of certain Active Pharmaceutical Ingredients (APIs) and Excipients when billed as part of a compounded drug claim
Approval Date: March 6, 2020
Effective Date: October 1, 2019
Topics: Benefits Eligibility Prescription Drugs

Indiana
Technical changes to the Child Mental Health Wraparound HCBS state plan benefit to correct errors in pagination resulting from the approved SPA TN 19-007. This SPA makes revisions to the qualification requirements for staff making level of need determinations to allow for the inclusion of experience in areas closely related to wraparound services to count towards an individual’s experience, in addition to clinical experience.
Approval Date: March 5, 2020
Effective Date: November 1, 2019

Indiana

Transmittal Number (TN) 19-014 Child Mental Health Wraparound §1915(i) home and community-based services (HCBS) state plan amendment (SPA)  makes technical changes to correct errors in pagination

Approval Date: March 5, 2020
Effective Date: November 1, 2019
Topics: Children's Health Insurance Program Current State Plan Program Administration

Kansas
The Behavioral Health Peer Support Services reimbursement rates will increase by l0%
Approval Date: March 5, 2020
Effective Date: January 1, 2020

New Mexico
Medicaid Drug Utilization Review (DUR)
Approval Date: March 5, 2020
Effective Date: October 1, 2020
Topics: Program Administration

Mississippi
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.
Approval Date: March 5, 2020
Effective Date: October 1, 2019
Topics: Program Administration

Wisconsin
Updates WI's drug utilization program provisions to include requirements established in the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act
Approval Date: March 5, 2020
Effective Date: October 1, 2019

North Dakota
Reimbursement update for Pharmacy SUPPORT Act DUR SPA
Approval Date: March 4, 2020
Effective Date: October 1, 2019
Topics: Financing & Reimbursement