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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 5181 - 5190 of 15696

California
One-year reimbursement rate add-on for ground emergency medical transports with dates of service between July 1, 2020 and June 30, 2021
Approval Date: October 15, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

Oklahoma
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 supplemental reimbursement for nursing facility ventilators related to the cost of care.
Approval Date: October 15, 2020
Effective Date: July 1, 2020
Topics: Disaster Relief Financing & Reimbursement

Mississippi
allow the state to revise the Medicare fee schedule update frequency from quarterly to annually. It also proposes to reimburse physician-administered drugs at Wholesale Acquisition Cost (WAC) +0% if there is no Medicare Part B Drug Fee Schedule or Medicare Addendum B OPPS Fee Schedule rate available.
Approval Date: October 14, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

Virginia
Updates coverage and documentation requirements for enteral nutrition and allow the use of implantable pumps for delivering home infusion therapy
Approval Date: October 14, 2020
Effective Date: August 30, 2020

Kansas
establishes the reimbursement rate for wheelchair seating assessments and caps those assessments at $500 per year per beneficiary
Approval Date: October 14, 2020
Effective Date: July 1, 2020
Topics: Benefits Financing & Reimbursement

Michigan
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this SPA is to request an increase in payment rates for Personal care services, behavioral health treatment behavior technician services, and services provided by registered nurses, licensed practical nurses, competency-evaluated nursing assistants, and respiratory therapists employed by Medicaid-certified nursing facilities.
Approval Date: October 12, 2020
Effective Date: October 1, 2020
Topics: Disaster Relief Financing & Reimbursement

North Dakota
remove the restriction on providers who can enroll to render Targeted Case Management (TCM) for individuals with a Serious Mental Illness (SMI) or Serious
Emotional Disturbance (SED).
Approval Date: October 8, 2020
Effective Date: May 1, 2020
Topics: Program Administration

Louisiana
Amendment is to modify third party liability (TPL) rules related to special treatment of certain types of care and payment and to allow for payment up to 100 days after a claim is submitted for claims related to support enforcement; to modify TPL rules around preventive pediatric services; and to modify the cost avoidance changes for prenatal services and coordination of benefits cost avoidance when processing claims for prenatal services, including labor and delivery, and postpartum care claims.
Approval Date: October 8, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

North Dakota
Provides a yearly inflationary increase for EPSDT services reimbursement rates as of July 1, 2020
Approval Date: October 7, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

Utah
Adjusts the Outpatient Prospective Payment System (OPPS) payments.
Approval Date: October 7, 2020
Effective Date: October 1, 2020
Topics: Financing & Reimbursement