U.S. flag

An official website of the United States government

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 3791 - 3800 of 15693

Texas
This amendment proposes to add medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan.
Approval Date: March 15, 2022
Effective Date: October 1, 2020
Topics: Drugs and Related Services

Alabama
This amendment will allow for case management services to assist Medicaid eligible pregnant women of any age medical and social services.
Approval Date: March 15, 2022
Effective Date: January 1, 2022

Missouri

Annual assurances of the pharmacy program adherence to the requirement of federal regulations regarding expenditures for multiple source drugs.

Approval Date: March 15, 2022
Effective Date: October 1, 2021
Topics: Federal Upper Limit Program Administration

Louisiana
The purpose of this SPA is to amend the provisions governing Federally Qualified Health Centers (FQHCs) in order to establish that where payment(s) from managed care organizations (MCOs) are less than the Alternative Payment Methodology (APM), the FQHC will be eligible to receive a Wrap-around supplemental payment processed and paid by the Louisiana Department of Health.
Approval Date: March 14, 2022
Effective Date: January 27, 2022
Topics: Financing & Reimbursement

Missouri

This State Plan Amendment includes the following revisions to Certified Community Behavioral Health services:

  •  Removes face-lo-face requirement in order to constitute a visit;
  • Adds telemedicine and mobile unit as a place of service;
  • Clarifies definition of crisis intervention;
  • Updates practitioners who can provide services and also name of practitioner with;
  • Adds Resident Physician as a qualifying practitioner; and,
  • Updates rate methodology pages for effective date rate methodology for initial payment rates and for rate reconsiderations, and quality incentive payment.
Approval Date: March 14, 2022
Effective Date: April 1, 2022

North Dakota
Update the PCCM program to allow individuals to change their PCP without cause, and mandates enrollment for 19 and 20-year-old individuals who are eligible under Medicaid expansion.
Approval Date: March 11, 2022
Effective Date: January 1, 2022
Topics: Benefits Program Administration

Colorado
Changes the payment methodology for Federally Qualified Health Centers (FQHCs) to reimburse FQHCs a per member per month (PMPM) rate instead of an encounter rate for medical services for attributed members.
Approval Date: March 11, 2022
Effective Date: July 1, 2021
Topics: Financing & Reimbursement

Georgia
This amendment proposes to provide attestation of transportation minimum requirements.
Approval Date: March 10, 2022
Effective Date: October 1, 2021

Rhode Island
Home Care Temporary Rate Increases
Approval Date: March 10, 2022
Effective Date: November 1, 2021
Topics: Financing & Reimbursement

Puerto Rico
To update policies regarding how Medicaid applications may be submitted, the frequency and methods used for renewal of eligibility, requirements when determining ineligible assistance with application and renewal notice requirements and the use of authorized representatives.
Approval Date: March 9, 2022
Effective Date: June 1, 2021