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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 5121 - 5130 of 15696

Idaho
modifies the methodology in which nursing facilities (NFs) receive supplemental payment through their NF upper payment limit (UPL) supplemental payment program. 
Approval Date: November 9, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

North Carolina
proposes to change methodologies for calculating the inpatient UPL.  The state will change from a DRG methodology to a per diem methodology
Approval Date: November 9, 2020
Effective Date: February 1, 2020
Topics: Financing & Reimbursement Program Administration

North Carolina
 This SPA modifies Attachment 4.19-A of North Carolina’s Title XIX State Plan.  Specifically this amendment proposes to modify the language describing reimbursement to NC state border hospitals in need of inpatient services.   
Approval Date: November 9, 2020
Effective Date: February 1, 2020
Topics: Financing & Reimbursement

Indiana
makes changes to implement an end of therapy reclassification methodology in the RUG IV, 48-Group model for payment of nursing facilities
Approval Date: November 9, 2020
Effective Date: July 1, 2020
Topics: Program Administration

Arkansas
amendments to include new therapy Current Procedural Terminology (CPT) evaluation codes
Approval Date: November 9, 2020
Effective Date: January 1, 2021
Topics: New Labeler Codes Program Administration

Wisconsin
Updates the income disregard for several eligibility groups in the state plan.
Approval Date: November 6, 2020
Effective Date: July 1, 2020
Topics: Program Administration

California

This SPA updates the third-party liability section of the state plan to use standard coordination of benefits cost avoidance when processing claims for prenatal services.

Approval Date: November 6, 2020
Effective Date: October 1, 2020

New Mexico
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to increase the dispensing fee for curbside pharmacy services.
Approval Date: November 5, 2020
Effective Date: October 1, 2020
Topics: Disaster Relief Financing & Reimbursement Prescription Drugs

Virginia
The purpose of this SPA is to update the ARTS state plan pages to incorporate general updates to the program, including updates related to medication assisted treatment, defining the scope of practice for certified substance abuse counselors, including substance use disorder counseling within that scope, and guidance related to telemedicine requirements.
Approval Date: November 5, 2020
Effective Date: October 1, 2020
Topics: Current State Plan Program Administration

New Mexico
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to increase reimbursement to non-hospital providers.
Approval Date: November 4, 2020
Effective Date: April 1, 2020
Topics: Disaster Relief Financing & Reimbursement