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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 4851 - 4860 of 15707

Massachusetts
This is an amendment to rates for nursing facilities and establishes additional payment methodologies associated with COVID-19 supports and oversights for fiscal year 2021.
Approval Date: March 26, 2021
Effective Date: October 1, 2020
Topics: Financing & Reimbursement

Nevada
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to update the Other Licensed Practitioners to include pharmacies, pharmacy interns, qualified pharmacy technicians, and licensed dental hygienists, and to allow for 100% Medicare payment for COVID-19 vaccine administration.
Approval Date: March 25, 2021
Effective Date: December 11, 2020
Topics: Benefits Disaster Relief Reimbursement

Massachusetts
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to add temporary rate increases for adult day health and day habilitation providers during the public health emergency. The Commonwealth proposes to change the unit rate from a 15 minute increment rate, to full day and partial day per diem rates.
Approval Date: March 25, 2021
Effective Date: August 1, 2020
Topics: Disaster Relief Reimbursement

Arizona
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to permit a second COVID-19 related direct payment for nursing facilities that is identical to the first approved payment. The payment for each provider is computed at $30 multiplied by the number of Medicaid fee-for-service bed days during the proxy period of 10/1/19 to 12/31/19.
Approval Date: March 25, 2021
Effective Date: January 1, 2021
Topics: Disaster Relief Reimbursement

Texas
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to allow licensed practitioners practicing within their scope of practice, such as nurse practitioners and physician assistants, to order Medicaid home health services during the COVID-19 pandemic.
Approval Date: March 25, 2021
Effective Date: March 18, 2021
Topics: Benefits Disaster Relief

Virgin Islands
 This amendment proposes adding coverage and payment methodology of Personal Care Attendant Services (PCAP) in the U.S. Virgin Islands Medicaid program, approved initially on March 25, 2021.  At the time of approval, the end of the PHE was not known.  Now that the date is known, this SPA has been updated to reflect an effective of May 12, 2023.
Approval Date: March 25, 2021
Effective Date: May 12, 2023
Topics: Coverage Financing & Reimbursement

Montana
This amendment modifies the state’s paper and online applications to integrate eligibility for the state’s 1115 family planning demonstration waiver into the state’s Medicaid eligibility application and eligibility determination system. The changes are limited to inclusion of two additional questions to ensure an applicant can apply and be determined eligible for family planning coverage, as provided under Montana’s section 1115 family planning demonstration.
Approval Date: March 25, 2021
Effective Date: March 25, 2021
Topics: Eligibility Program Administration

Louisiana
The amendment is to comply with the Louisiana regulations related to transfer of assets in the Medicaid assistance program.
Approval Date: March 25, 2021
Effective Date: October 1, 2020
Topics: Program Administration

Rhode Island
The purpose of this amendment is to add a cost-based reimbursement methodology for state-owned inpatient hospital services. 
Approval Date: March 25, 2021
Effective Date: April 1, 2020
Topics: Financing & Reimbursement

Hawaii
Effective January 13, 2021, this amendment increases the component prices for private nursing facility rates by 12 percent. 
Approval Date: March 25, 2021
Effective Date: January 13, 2021
Topics: Financing & Reimbursement