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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 4571 - 4580 of 15708

Oklahoma
Effective the day after the Public Health Emergency (PHE) ends, this amendment revises the providers that can order home health services. In addition to physicians, the amendment allows nurse practitioners, clinical nurse specialists, or physician assistants, working in accordance with State law, to order home health services to comply with federal regulation. 
Approval Date: June 23, 2021
Effective Date: No Effective Date
Topics: Benefits Program Administration

Montana
Effective April 1, 2021, this amendment adds Licensed Marriage and Family Therapists to the approved Other Licensed Practitioners (OLP) in the state plan, including as recognized licensed OLP Dually Licensed Practitioners. In addition, this amendment adds a reimbursement methodology for Licensed Marriage and Family Therapist practitioner and updates the existing OLP benefit pages.
Approval Date: June 23, 2021
Effective Date: April 1, 2021
Topics: Benefits Program Administration

Louisiana
Effective February 20, 2021, this amendment is to amend the provisions governing laboratory and radiology services in order to ensure that the existing language reflects current practices, remove coding and billing instructions and other extraneous information.
Approval Date: June 23, 2021
Effective Date: February 20, 2021
Topics: Financing & Reimbursement Program Administration

Tennessee

Mandatory Coverage of Medication-Assisted Treatment (MAT) under section 1006 (b) of the SUPPORT Act.

Approval Date: June 23, 2021
Effective Date: October 1, 2020
Topics: Program Administration

Arizona
This amendment updates the inpatient hospital Differential Adjusted Payment (DAP) program effective October 1, 2020.
Approval Date: June 23, 2021
Effective Date: October 1, 2020
Topics: Financing & Reimbursement

Mississippi
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 reimburse long-term care facilities licensed in Mississippi an add-on payment of $13.00 per day per beneficiary for claims for dates of service from January 1, 2021 through June 30, 2021.
Approval Date: June 23, 2021
Effective Date: January 1, 2021
Topics: Disaster Relief Reimbursement

Utah
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 establish coverage of COVID-19 vaccine administration and a reimbursement rate for COVID-19 vaccine administration.
Approval Date: June 23, 2021
Effective Date: December 11, 2020
Topics: Benefits Disaster Relief Reimbursement

Missouri
Effective October 1, 2020 until September 30, 2025, pursuant to Section 1006(b) of the SUPPORT Act, this amendment address the newly added mandatory benefit for coverage and reimbursement of medication-assisted treatment (MAT) in opioid treatment programs (OTPs) and office-based opioid treatment setting in compliance with Section 1006(b) of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, HR 6, and, Section 1905 (a) (29) of the Social Security Act. 
Approval Date: June 22, 2021
Effective Date: October 1, 2020

Virginia
Effective February 24, 2021, this amendment adds payment for tribal health clinics including an alternate payment method for tribal Federally Qualified Health Center (FQHCs) equal to OMB all-inclusive rate. 
Approval Date: June 22, 2021
Effective Date: February 24, 2021
Topics: Financing & Reimbursement Tribal Issues

North Carolina
Effective January 1, 2021, this amendment updates program page language regarding Professional Treatment Services in Facility Based Crisis (FBC) programs for Children and Adolescents. 
Approval Date: June 22, 2021
Effective Date: January 1, 2021
Topics: Benefits Program Administration