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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 3891 - 3900 of 15693

Washington

Update the Fee-For Service supplemental payment amounts for Inpatient services described in the Medicaid State Plan for prospective payment hospitals other than psychiatric or rehabilitation hospitals, psychiatric hospitals, and rehabilitation hospitals to align with APR-DRG update.

Approval Date: February 8, 2022
Effective Date: October 1, 2021
Topics: Financing & Reimbursement

California
This SPA will exempt from estate recovery any payment made to qualified recipients of the Forced or Involuntary Victim Compensation Program following the death of a qualified Medicaid member.
Approval Date: February 8, 2022
Effective Date: March 31, 2022

North Carolina
Allows Clinical Coverage Policy (CCP) 8A Substance Abuse Demonstration (SUD) Flexibilities.
Approval Date: February 7, 2022
Effective Date: October 1, 2021
Topics: Benefits Program Administration

District of Columbia
Allows Dual Special Needs Plans to contract to furnish previously approved ADHP services under the provisions of §1915(a)(l ), which serves all geographic areas in the District, through capitated monthly payments made to the health plan.
Approval Date: February 7, 2022
Effective Date: February 7, 2022
Topics: Benefits Program Administration

Ohio
This amendment updates Ohio’s Comprehensive Primary Care (CPC) and CPC for Kids programs for the 2022 program year.
Approval Date: February 7, 2022
Effective Date: January 1, 2022
Topics: Coverage Financing & Reimbursement

New Jersey

Suspends the Medicaid Recovery Audit Contractor Program, a requirement in section 1902(a)(42)(B)(i) of the Social Security Act, for a two year-year period because ninety-seven percent of Medicaid beneficiaries participate in managed care.

Approval Date: February 7, 2022
Effective Date: January 1, 2022
Topics: Program Administration

Oregon
Continues flexibilities granted in the Oregon 1915(k) Community First Choice State Plan Option beyond the end of the Public Health Emergency (PHE).
Approval Date: February 7, 2022
Effective Date: April 16, 2022
Topics: Program Administration

Utah
assures the State complies with the federal medical transpo1iation requirements added by the Consolidated Appropriations Act, 2021.
Approval Date: February 7, 2022
Effective Date: October 1, 2021
Topics: Program Administration

Massachusetts
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to rescind  rates approved in DR SPA 20-0008 effective 1/1/21.
Approval Date: February 4, 2022
Effective Date: January 1, 2021
Topics: Disaster Relief Reimbursement

Minnesota
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to establish a new threshold for determining when to seek recovery of reimbursement from a liable third party for COVID-19 testing and associated laboratory services administered through public health agencies.
Approval Date: February 4, 2022
Effective Date: March 1, 2020