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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 5061 - 5070 of 15696

Michigan
establishes Alternative Benefit Plan(ABP) MI uses to implement requirements of the Healthy Michigan Plan(HMP)
Approval Date: December 3, 2020
Effective Date: August 1, 2020
Topics: Benefits Program Administration

Michigan
Implements new federal regulations to permit non-physician practitioners (e.g., nurse practitioners, physician assistants, and clinical nurse specialist) to order home health services and durable medical equipment.
Approval Date: December 3, 2020
Effective Date: August 1, 2020
Topics: Program Administration

South Carolina

This SPA includes reimbursement methods that use, among others, the National Average Drug Acquisition Cost (NADAC), plus a professional dispensing fee of $10.50 for covered outpatient drugs. This SPA also includes reimbursement rates for 340B drugs, long-term care and specialty drugs, drugs purchased at a nominal price, and physician administered drugs.

Approval Date: December 3, 2020
Effective Date: July 15, 2020
Topics: Covered Outpatient Drug Reimbursement

Virginia
This amendment establishes an additional disporportionate share hospital payment to non-state government owned acute care hospitals and applies nursing facility inflation rates to specialized care facilities. 
Approval Date: December 2, 2020
Effective Date: July 1, 2020
Topics: Program Administration

Maine
Increases reimbursement for personal care services and private duty nursing services.  
Approval Date: December 2, 2020
Effective Date: July 1, 2016
Topics: Financing & Reimbursement

Indiana
establishes the Disproportionate Hospital Share (DSH) allocation
Approval Date: December 1, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

South Dakota
Removes the face-to-face requirement for community mental health center providers.
Approval Date: December 1, 2020
Effective Date: July 21, 2020
Topics: Program Administration

Florida
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 State Plan to include emergency provisions including: suspension of co-payments, adjust current benefits, expand telemedicine services, increase payment rates, eliminate sanctions for cost reports, and modify occupancy limits.
Approval Date: November 24, 2020
Effective Date: March 9, 2020
Topics: Benefits Cost Sharing Disaster Relief Prescription Drugs Reimbursement

North Dakota
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 the state to waive the 24 day limit for payment for a reserved day for therapeutic leave of absences for a resident of a nursing facility.
Approval Date: November 24, 2020
Effective Date: March 1, 2020
Topics: Disaster Relief Reimbursement

New Jersey
authorizes supplemental safety net payments to qualifying county nursing facilities.
Approval Date: November 24, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement