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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 3921 - 3930 of 15690

Montana
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 effective April 1, 2021, add single case agreement language to inpatient hospital out of state provider payment methodology. Effective July 1, 2021, it also adds reimbursement for Crisis Assessment services conducted after hours.
Approval Date: February 2, 2022
Effective Date: April 1, 2021
Topics: Disaster Relief Reimbursement

Washington
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 enable the State to receive federal Medicaid matching funds for fee-for-service COVID-19-related supplemental payments to Small Rural Disproportionate Share Hospitals (SRDSH).
Approval Date: February 2, 2022
Effective Date: March 1, 2020
Topics: Disaster Relief Reimbursement

Oklahoma
Revises the language describing the methodology used to calculate the capitation rate payment for PACE organizations. The SPA will remove the Medicare Economic Index ( MEI) adjustment from the rate methodology, as the PACE capitation rate is based on the amount that would otherwise be paid (AWOP) which is reviewed annually and adjusted as needed, without regard to the MEI.
Approval Date: February 2, 2022
Effective Date: November 3, 2021
Topics: Benefits Program Administration

Florida
Provides assurance of transportation requirements in accordance with Section 209 of the Consolidated Appropriations Act of 2021
Approval Date: February 1, 2022
Effective Date: December 27, 2021
Topics: Program Administration

Pennsylvania
amend Attachment 4.22-B of the state plan to reflect Pennsylvania’s compliance with the third-party liability requirements of the Bipartisan Budget Act of 2018 and the Medicaid Services Investment and Accountability Act of 2019.
Approval Date: February 1, 2022
Effective Date: December 31, 2021
Topics: Program Administration

Minnesota
This plan amendment updates the rates for Youth Assertive Community Treatment (ACT).
Approval Date: January 31, 2022
Effective Date: January 1, 2022
Topics: Financing & Reimbursement

South Carolina
Annual update to the State’s supplemental teaching physician payment program using the Average Commercial Rate.
Approval Date: January 28, 2022
Effective Date: April 1, 2021
Topics: Program Administration

Kentucky
To adopt the optional eligibility group serving individuals eligible for the Medicaid Program for All-Inclusive Care for the Elderly (PACE).
Approval Date: January 28, 2022
Effective Date: July 1, 2021

Kansas
This amendment proposes revisions to bring Kansas' State Plan into compliance with recent guidance requiring states to assure necessary transportation for beneficiaries to and from covered services
Approval Date: January 27, 2022
Effective Date: October 1, 2022
Topics: Coverage Financing & Reimbursement

Colorado
Establishes authority to negotiate a higher inpatient hospital payment rate for circumstances where the inpatient methodology is insufficient for the high acuity, all other placement options have been exhausted, and the service has received prior authorization from the Department’s medical consultant.
Approval Date: January 27, 2022
Effective Date: May 14, 2021
Topics: Financing & Reimbursement