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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 2741 - 2750 of 15693

Ohio
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to resume prior authorization of private duty nursing (PDN) services and home health (HH) services that were approved in Ohio DR SPA 20-0012 on 5/22/20 in response to the COVID-19 PHE and resumes review of the normal limits on PDN & HH services with a process to exceed based on medical necessity.
Approval Date: January 27, 2023
Effective Date: October 1, 2022
Topics: Benefits Disaster Relief Eligibility

Oregon
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to provide incentive payments to residential facilities to encourage discharges from hospitals.
Approval Date: January 27, 2023
Effective Date: November 1, 2022
Topics: Disaster Relief Reimbursement

Indiana
This plan amendment updates the reimbursement methodology for Medicaid reimbursement for Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) to reimburse COVID-19 vaccine administration.
Approval Date: January 27, 2023
Effective Date: July 1, 2021

Louisiana
The purpose of this SPA is to amend the provisions governing reimbursement for personal care services (PCS) provided to beneficiaries in the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program in order to remove outdated language regarding a wage enhancement that is not applicable to the current EPSDT-PCS program.
Approval Date: January 27, 2023
Effective Date: February 20, 2023

Maryland
This amendment rebases the rate for Residential Treatment Centers to $850 per day, updated annually based on CMS published market basket increase percentage relating to hospitals.
Approval Date: January 27, 2023
Effective Date: January 1, 2023

Minnesota
This plan amendment updates the rates for Adult Foster Care.
Approval Date: January 27, 2023
Effective Date: January 1, 2023

Louisiana
The purpose of this SPA is to amend the provisions governing inpatient hospital services in order to expand the qualifications for classification as a teaching hospital to include facilities that have documented affiliation agreements with Louisiana medical schools accredited by the Commission of Osteopathic College Accreditation (COCA).
Approval Date: January 27, 2023
Effective Date: January 20, 2023

New York
to decrease the administrative burden on enrolled fee-for-service Medicaid members and providers but will continue to meet the federal regulatory requirements at 42 CFR Part 456, Subparts A and B. This will be accomplished through continued utilization monitoring in a postpayment review process, with referral to the Office of Health Insurance Program (OHIP) prepayment Provider on Review Program, and to the Office of the Medicaid Inspector General (OMIG) where suspected fraud, waste or abuse are identified in the unnecessary or
inappropriate use of care, services or supplies by members or providers.
Approval Date: January 26, 2023
Effective Date: October 1, 2022

Maine
This plan amendment authorizes a 4.9% rate increase for Family Planning and Supplies
services that do not have a Medicare rate.
Approval Date: January 26, 2023
Effective Date: July 1, 2022

California
This amendment is to add doula services under the preventive services benefit and as a professional service under the freestanding birth center benefit.
Approval Date: January 26, 2023
Effective Date: January 1, 2023
Topics: Coverage Reimbursement