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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 4681 - 4690 of 15708

Texas
Effective June 1, 2021, this amendment updates the non-emergency medical transportation (NEMT) fee schedules and requires managed care organizations (MCOs) to provide NEMT services to their Medicaid managed care members. The Health and Human Services Commission (HHSC) will continue to provide NEMT to Medicaid recipients in fee-for-service but will no longer use a transportation broker model.
Approval Date: May 25, 2021
Effective Date: June 1, 2021
Topics: Benefits Financing & Reimbursement

Louisiana
Complies with Section 1006(b) of the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act and State Health Official (SHO) Letter #20-005, by continuing access to medication-assisted treatment (MAT) for opioid use disorders (OUD) through Medicaid coverage of certain drugs and biological products and related counseling services and behavioral therapy.
Approval Date: May 25, 2021
Effective Date: October 1, 2020
Topics: Program Administration

Pennsylvania
Reauthorizes and continues a series of additional classes of DSH payments and two targeted supplemental payments for qualifying private acute care hospitals.
Approval Date: May 24, 2021
Effective Date: February 28, 2021
Topics: Financing & Reimbursement

New Hampshire
Effective January 1, 2020, this amendment increases various inpatient hospital "price per point" rates, generally by 3.1 percent. 
Approval Date: May 24, 2021
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Pennsylvania
reauthorizes and continues a series of additional classes of DSH payments and two targeted supplemental payments for qualifying private acute care hospitals.
Approval Date: May 24, 2021
Effective Date: February 28, 2021
Topics: Financing & Reimbursement

Mississippi
Effective January 1, 2021, this amendment allows the Division of Medicaid (DOM) to remove the list of specific Current Dental Terminology (CDT) codes.
Approval Date: May 24, 2021
Effective Date: January 1, 2021
Topics: Benefits Current State Plan Program Administration

Connecticut
Effective January 1, 2021, this amendment incorporates various 2021 Healthcare Common Procedure Coding System (HCPCS) updates, updated the reimbursement methodology to 100% of the January 2021 Medicare Average Sales Price (ASP) Drug Pricing file for physician-administered drugs, immune globulins, vaccines and toxoids and made technical updates to the Person-Centered Medical Home (PCMH) program.
Approval Date: May 24, 2021
Effective Date: January 1, 2021
Topics: Current State Plan Financing & Reimbursement

Ohio
Effective January 1, 2021, this amendment updates the Non-Institutional Payment Schedules for 2021. 
Approval Date: May 24, 2021
Effective Date: January 1, 2021
Topics: Financing & Reimbursement

Pennsylvania
This amendment will continue certain benefits changes beyond the end of the COVID-19 Public Health Emergency (PHE).  The home health, prescription drug, targeted case management, and nursing facility benefits in this SPA was originally approved on May 24, 2021.  At the time of approval, the end date of the PHE was not known.  Now that the date is known, this SPA has been updated to reflect an effective date of May 12, 2023.
Approval Date: May 24, 2021
Effective Date: May 12, 2023

Rhode Island
Home Care Rate Increases and Enhancements
Approval Date: May 23, 2021
Effective Date: July 1, 2021
Topics: Financing & Reimbursement