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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 4641 - 4650 of 15708

Maryland
This amendment provides a four percent increase for targeted case management services. 
Approval Date: June 4, 2021
Effective Date: January 1, 2021
Topics: Financing & Reimbursement

Minnesota
This plan amendment updates the Resource Based Relative Value Scale conversion
factors for Physician services.
Approval Date: June 4, 2021
Effective Date: January 20, 2021
Topics: Financing & Reimbursement

New York
This amendment revises the State Plan to establish and authorize payment for rehabilitative and preventative services delivered to children residing in a structured and supportive living environment.
Approval Date: June 4, 2021
Effective Date: February 1, 2021

New York
Effective January 21, 2020, this amendment updates the New York State Department of Health's Ambulatory Patient Group (APG) methodology for Outpatient Hospitals. 
Approval Date: June 3, 2021
Effective Date: January 21, 2021
Topics: Financing & Reimbursement Program Administration

Colorado
Allows for a change to the Department’s payment methodology for Targeted Case Management Services: Persons with a Developmental Disability to a per member per month (PMPM) structure
Approval Date: June 3, 2021
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

South Carolina
This plan amendment updates the name of the designee to submit State Plan Amendments (SPAs) for the state of South Carolina.
Approval Date: June 3, 2021
Effective Date: April 20, 2021

South Carolina

The primary purpose of this plan amendment is to seek an exception to 42 CFR & 455.508 (b) the requirement that the Medicaid Recovery Audit Contractor (RAC) program must hire a minimum of 1.0 FTE Contractor Medical Director.

Approval Date: June 3, 2021
Effective Date: January 1, 2021
Topics: Program Administration

Michigan
Medicaid Recovery Auditor Contractor (RAC) Program Process Exception
Approval Date: June 3, 2021
Effective Date: April 1, 2021
Topics: Program Administration

Massachusetts
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 certain specifically listed clinical laboratory services, including COVID-19 specimen collection and testing, with updated fee schedules.
Approval Date: June 2, 2021
Effective Date: March 1, 2020
Topics: Disaster Relief Reimbursement

Virginia
Effective October 1, 2020 until September 30, 2025, this amendment addresses the newly added mandatory benefit for coverage and reimbursement of medication-assisted treatment (MAT) in opioid treatment programs (OTPs) and office-based opioid treatment settings. The purpose of the SPA is to move Virginia’s current MAT benefit from the optional benefit section in Virginia’s state plan to the required benefit section to comply with Section 1006(b) of the SUPPORT Act.
Approval Date: June 2, 2021
Effective Date: October 1, 2020
Topics: Benefits Financing & Reimbursement Prescription Drugs