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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 621 - 630 of 15693

New York

To establish Medical Assistance coverage and rates of payment for Coordinated Specialty Care (CSC), an evidence-based practice model for the treatment of young people experiencing a first episode of psychosis (FEP).

Approval Date: September 26, 2024
Effective Date: July 1, 2023

Utah

This amendment confirms third-party payer responsibilities in accordance with the Consolidated Appropriations Act of 2022.

Approval Date: September 26, 2024
Effective Date: September 1, 2024

Massachusetts

This plan amendment updates the rate year 2024 reimbursement for inpatient acute psychiatric hospital services. Specifically, it establishes reimbursement for certain long acting injectable antipsychotic pharmaceuticals covered by MassHealth in addition to the psychiatric per diem rate; and makes technical edits to the Adjudicated Payment Amount Per Discharge (APAD) payment methodology for certain pediatric discharges.

Approval Date: September 25, 2024
Effective Date: May 15, 2024

Massachusetts

This plan amendment updates the rate year 2024 reimbursement for privately-owned inpatient psychiatric hospital services. Specifically, it establishes a reimbursement methodology for certain long-acting injectable (LAI) antipsychotic pharmaceuticals covered by MassHealth in addition to the psychiatric per diem rate.

Approval Date: September 25, 2024
Effective Date: May 15, 2024

Michigan

This plan amendment continues the rate increase for Incontinence Volume Purchase Contract and non-sterile gloves.

Approval Date: September 25, 2024
Effective Date: October 1, 2024

Oregon

This plan amendment created an annual quality assurance fee on each emergency medical transport and established reimbursement to be paid to nonpublic emergency medical service providers.

Approval Date: September 25, 2024
Effective Date: April 1, 2023

New York

This plan amendment eliminates the existing sunset date for Certified Home Health Agencies (CHHA) episodic payment methodology.

Approval Date: September 25, 2024
Effective Date: April 1, 2019

New York

The Centers for Medicare & Medicaid Services (CMS) has reviewed the proposed New York state plan amendment (SPA) NY-24-0037 for NYS Health Home Program to adjust payment rates for a 2.84 percent (2.84%) cost of living adjustment and to allow supplemental payments intended for services provided to eligible adults who meet risk and acuity criteria for Health Home Plus and receiving Assisted Outpatient Treatment (AOT).

Approval Date: September 25, 2024
Effective Date: April 1, 2024

Colorado

This amendment adds Direct-Entry Midwives (also referred to as Certified Professional Midwives) to the midwifery provider types.

Approval Date: September 25, 2024
Effective Date: April 1, 2024
Topics: Coverage and Reimbursement

Michigan

Expands the list of applicable diagnoses to reflect the SUD-Health Home in conjunction with the related traditional SPA (MI 24-1501).

Approval Date: September 25, 2024
Effective Date: October 1, 2024
Topics: Alternative Benefit Plan