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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 2991 - 3000 of 15689

Arizona
Updates the state plan Nursing Facility (NF) rates.
Approval Date: November 10, 2022
Effective Date: October 1, 2022
Topics: Financing & Reimbursement

Arizona
Updates the state plan DRG rates.
Approval Date: November 10, 2022
Effective Date: October 1, 2022
Topics: Financing & Reimbursement

Indiana
This State Plan Amendment (SPA) looks to provide Medicaid coverage for eligible members to receive general pediatric vaccine counseling as part of EPSDT. Beginning with dates of service on or after September 1, 2022, stand-alone general pediatric vaccination counseling as part of the early and periodic screening, diagnostic, and treatment (EPSDT) benefit will be reimbursed under CPT 99401 with modifier EP per the fee schedule. This SPA also relocates payment for Ambulance Response and Treat-no-Transport Services for Emergency Medical Technicians (EMT's) under the direction of a physician.
Approval Date: November 10, 2022
Effective Date: September 1, 2022

Nebraska
SFY23 Nursing Facility Rates
Approval Date: November 10, 2022
Effective Date: July 1, 2022
Topics: Financing & Reimbursement

Pennsylvania
Continues supplemental payment funding for an additional class of acute care general hospitals to promote
quality medical services to individuals enrolled in the Pennsylvania Medical Assistance Program and provide financial relief to hospitals during the coronavirus pandemic.
Approval Date: November 10, 2022
Effective Date: October 9, 2022
Topics: Financing & Reimbursement

New Hampshire
Updates the nursing facility reimbursement rate budget adjustment factor as well as the Class Line 504 amount.
Approval Date: November 10, 2022
Effective Date: July 1, 2022

New Hampshire
Hospital-Based Birthing Services Rate Increase
Approval Date: November 10, 2022
Effective Date: July 1, 2022
Topics: Financing & Reimbursement

New York
Updates the Public General Hospital Outpatient Supplemental Payment Adjustment for the state fiscal year beginning April 1, 2020 and ending March 31, 2021.
Approval Date: November 10, 2022
Effective Date: April 1, 2020
Topics: Financing & Reimbursement

South Carolina
Updates ICF/IID rates effective Jan. 1, 2022 using the most recent cost report information available and updated trend factor.
Approval Date: November 10, 2022
Effective Date: January 1, 2022

Missouri
Allows for a rebase of the Nonstate-Operated Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/11O) services
Approval Date: November 10, 2022
Effective Date: October 1, 2022
Topics: Financing & Reimbursement