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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 2951 - 2960 of 15690

Pennsylvania
Continued use of the budget adjustment factor (BAF) for county nursing facility payment rates for the 2022-2023 through 2025-2026 rate years.
Approval Date: November 23, 2022
Effective Date: July 1, 2022
Topics: Financing & Reimbursement

Virginia
2022 Institutional Provider Reimbursement Changes
Approval Date: November 23, 2022
Effective Date: July 1, 2022

Ohio

This SPA approves language specifying that the Single Pharmacy Benefit Manager (SPBM) will follow Ohio’s Unified Preferred Drug List.

Approval Date: November 23, 2022
Effective Date: October 1, 2022
Topics: Covered Outpatient Drug Preferred Drug Lists Prescribed Drugs

Nebraska
Updates intermediate care facility for individuals with developmental disabilities (ICF‐DD) rates.
Approval Date: November 22, 2022
Effective Date: July 1, 2022

Utah
This amendment proposes to assure the American Rescue Plan Act’s (ARP) mandatory coverage of the COVID-19 vaccine, testing, and treatment without cost sharing.
Approval Date: November 21, 2022
Effective Date: March 11, 2022
Topics: Benefits Reimbursement

Nevada
This amendment proposes to assure the American Rescue Plan Act’s (ARP) mandatory coverage of the COVID-19 vaccine, testing, and treatment without cost sharing.
Approval Date: November 21, 2022
Effective Date: March 11, 2022
Topics: Benefits Reimbursement

Ohio
This amendment proposes to update the state plan by adding coverage and payment provisions for evaluation and management services provided by chiropractors, as permitted under state law.
Approval Date: November 21, 2022
Effective Date: June 13, 2022
Topics: Coverage and Reimbursement

Colorado
Authorizes tribal Federally Qualified Health Centers (FQHC) to bill Colorado Medicaid for covered services on a per-visit basis under contract to the tribal FQHC.
Approval Date: November 21, 2022
Effective Date: October 1, 2022
Topics: Reimbursement Tribal Issues

Colorado
Updates the supplemental payment pool amounts for the Rural Family Medicine Residency Development Payment, Family Medicine Residency Program Payment, State University Teaching Hospital Payment, Pediatric Major Teaching Payment and the Urban Safety Net Provider Payment.
Approval Date: November 21, 2022
Effective Date: July 1, 2022
Topics: Financing & Reimbursement

Iowa
Implements an increase for behavioral health intervention services (BHIS).
Approval Date: November 21, 2022
Effective Date: July 1, 2022
Topics: Financing & Reimbursement