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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 4001 - 4010 of 15689

Arizona
Attests to the state’s compliance with the third party liability requirements outlined in sections 1902(a)(25)(E) and 1902(a)(25)(F)(i) of the Social Security Act.
Approval Date: December 27, 2021
Effective Date: December 31, 2021
Topics: Program Administration

Connecticut
This amendment updates CT Alternative Benefit Plan (ABP) to reflect several updates to behavioral health services, including removing the requirements for registration for all routine outpatient behavioral health. This SP A also updates the ABP to reflect the resumption of authorization for intensive outpatient
services and removal of authorization for electroconvulsive therapy.
Approval Date: December 27, 2021
Effective Date: July 1, 2021

Indiana

This amendment modifed the Medicaid Rehabilitation Option (MRO) service requirements to allow other behavioral health professionals to provide MRO services, within their scope of practice and licensure, and to allow certain MRO services to be provided concurrently with other addiction treatment services.

Approval Date: December 27, 2021
Effective Date: January 1, 2022

Delaware
modifies the targeting criteria, by maintaining the minimum age as fourteen (14) and
removing the maximum age of twenty-five (25).
Approval Date: December 23, 2021
Effective Date: January 1, 2022
Topics: Eligibility Program Administration

Oregon
Renew Oregon’s 1915(i) State Plan HCBS benefit. The effective date for this renewal is January 1, 2022.
Approval Date: December 23, 2021
Effective Date: January 1, 2022

Colorado
adds clarifying language specific in how Graduate Medical Education (GME) payments are made to hospitals for inpatient and outpatient hospital services provided to Medicaid managed care clients.
Approval Date: December 23, 2021
Effective Date: October 1, 2021
Topics: Program Administration

North Dakota
This amendment expands the number of acceptable ICD_10 Diagnoses for individual with the diagnosis of brain injury, behavioral health condition and/or substance abuse disorder.
Approval Date: December 22, 2021
Effective Date: January 1, 2022
Topics: Benefits Delivery System

Virginia
Allows the pending, reviewing, and reduction of emergency department payment amounts for avoidable emergency room claims for state plan authorized fee-for-service benefits coded as 99282, 99283 and 99284.
Approval Date: December 22, 2021
Effective Date: July 1, 2020
Topics: Program Administration

Texas
This SPA proposes to revise the methodology for assessing payment adjustments for Potentially Preventable Readmissions.
Approval Date: December 22, 2021
Effective Date: September 1, 2021

Montana
Updates the reimbursement methodology for psychiatric residential treatment facility services for State Fiscal Year 2022.
Approval Date: December 22, 2021
Effective Date: July 1, 2021
Topics: Financing & Reimbursement