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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 3971 - 3980 of 15690

Michigan
Provides authority to make technical changes regarding Third Party Liability and coordination of benefits processing.
Approval Date: January 14, 2022
Effective Date: January 1, 2022
Topics: Program Administration

Connecticut
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 the flexibilities in which the state authorized a 90-day supply of medication other than controlled substance medications and allowed prescription refills when 80% or more of the prescription was used.
Approval Date: January 14, 2022
Effective Date: April 19, 2021
Topics: Disaster Relief Prescription Drugs

Maine
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to make Hospital APC payments for vaccine administration equals 100% of Maine Medicare rate; add/adjust reimbursement for medication management by Behavioral Health providers; implement a one-time supplemental payment of $23 million (inpatient $12.5 million/outpatient $10.5 million); implement a supplemental payment of $2,079,376 to Adult Family Care Services providers, add crisis services under behavioral health professional; and allow several providers to provide crisis services.
Approval Date: January 14, 2022
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief Reimbursement

Michigan
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 allow for a temporary change to the nursing facility rate setting methodology.
Approval Date: January 14, 2022
Effective Date: October 1, 2021
Topics: Disaster Relief Reimbursement

Utah
Provides assurances that the State is in compliance with federal regulations regarding third party liability.
Approval Date: January 14, 2022
Effective Date: October 1, 2022

Minnesota
Provides requirements for Non-Emergency Medical Transportation (NEMT).
Approval Date: January 13, 2022
Effective Date: December 27, 2021
Topics: Program Administration

New Hampshire
NEMT Assurance
Approval Date: January 13, 2022
Effective Date: October 1, 2021
Topics: Program Administration

Oklahoma
establishes the reimbursement rate for intensive residential substance use disorder (SUD) treatment for adolescents (clinically managed medium intensity residential services for adolescents, intensive).
Approval Date: January 12, 2022
Effective Date: October 1, 2021
Topics: Benefits Program Administration

Oklahoma
CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to establish coverage and reimbursement for all FDA authorized self-collected COVID-19 tests inclusive of those requiring laboratory processing.
Approval Date: January 12, 2022
Effective Date: August 30, 2021
Topics: Benefits Disaster Relief Reimbursement

Missouri
Updates the Primary Care Physician Consultant to the Specialized Healthcare Consultant, allowing Health Homes flexibility in offering additional consultation from a variety of healthcare professions for special populations. Also updates the Per Member Per Month (PMPM) payment for Community Mental Health Centers (CMCH) Health Homes.
Approval Date: January 12, 2022
Effective Date: October 1, 2021