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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 5211 - 5220 of 15696

Illinois
Increase rates of reimbursement for mental health and substance use disorder services.
Approval Date: September 29, 2020
Effective Date: July 1, 2020
Topics: Program Administration Reimbursement

District of Columbia
updates the Medicaid fee schedule to add reimbursement for medical alert devices under state plan home health benefit
Approval Date: September 29, 2020
Effective Date: October 1, 2020

Montana
Effective for services on or after July 1, 2020, this amendment updates the fee schedule for Psychiatric Residential Treatment Facilities (PRTF) for state fiscal year 2020.   
Approval Date: September 29, 2020
Effective Date: July 1, 2020
Topics: Current State Plan Financing & Reimbursement

Indiana
makes technical changes to the template utilized in administering the supplemental drug rebate program.
Approval Date: September 28, 2020
Effective Date: September 1, 2020
Topics: Additional Rebate Calculation Revision Program Administration

Michigan
Updates the contract template used by MDHHS to enter into outcomes-based contest arrangements with drug manufactures.
Approval Date: September 28, 2020
Effective Date: July 31, 2020
Topics: Program Administration

Texas
This amendment proposes to revise the Texas State plan to incorporate language that authorizes the state to negotiate value-based
purchasing arrangements with drug manufacturers.
Approval Date: September 28, 2020
Effective Date: June 1, 2020
Topics: Benefits Prescription Drugs

South Carolina
add reimbursement for Therapeutic Foster Care (TFC) and the corresponding billing code for use by Child Placing Agencies (CPAs) contracted with the South Carolina Department of Social Services (SCDSS)
Approval Date: September 28, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

District of Columbia
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 the District of Columbia Medicaid program to make retainer payments to Adult Day Health Program (ADHP) providers whose operations have been impacted by the ongoing public health crisis related to COVID-19.
Approval Date: September 25, 2020
Effective Date: March 12, 2020
Topics: Disaster Relief Financing & Reimbursement

Montana
apply a census income disregard for Medicaid eligibility groups subject to non-MAGI income methodology, and to migrate eligibility requirements already approved for those non-MAGI eligibility groups into the state plan. Additionally, this state plan amendment revises the MAGI
methodology to account for reasonably predictable 
Approval Date: September 25, 2020
Effective Date: April 1, 2020
Topics: Eligibility Program Administration

North Dakota
Amends the State Plan to increase the eligibility income level for pregnant women to 157% of the Federal Poverty Level.
Approval Date: September 25, 2020
Effective Date: January 1, 2020
Topics: Eligibility Program Administration