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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 5281 - 5290 of 15820

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 expand telehealth, extend all prior authorization by automatic renewal without clinical review or time/quantity extensions, and adjust prior authorizations for medications.
Approval Date: October 23, 2020
Effective Date: March 18, 2020
Topics: Benefits Disaster Relief Prescription Drugs

Washington
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to rescind the following parts of Section 7.4 of the existing state plan: 1) Election A.1 to furnish medical assistance to uninsured group under 1902(a)(10)(A)(ii)(XXIII) and 1902(ss) of the Act; and 2) Election of B.1. to allow hospitals to make presumptive eligibility determinations for uninsured individuals described at section 1902(a)(10)(A)(ii)(XXIII) of the Social Security Act.
Approval Date: October 23, 2020
Effective Date: March 18, 2020
Topics: Disaster Relief Eligibility

California
Targeted Case Management Services for All Medicaid Eligible Children
Approval Date: October 22, 2020
Effective Date: January 2, 2016

Connecticut
amends reimbursement for inpatient hospital services for State Fiscal Year (SFY) 2021.
Approval Date: October 22, 2020
Effective Date: July 1, 2020

Nebraska
updates the nursing facility rate methodology and rates for state fiscal year 2021
Approval Date: October 22, 2020
Effective Date: July 1, 2020
Topics: Financing & Reimbursement

New Hampshire
Revises the January 2020 nursing home supplemental payment, also known as MQIP
Approval Date: October 22, 2020
Effective Date: October 1, 2019
Topics: Program Administration

New Hampshire
revises NH supplemental payment also known as MQIP for October 2019 payment
Approval Date: October 22, 2020
Effective Date: July 1, 2019
Topics: Financing & Reimbursement

California
Implements California Assembly Bill (AB) 1088 (Chapter 450, 2019) for a new income disregard that would allow an aged, blind, or disabled individual to remain eligible for the Aged, Blind, and Disabled Federal Poverty Level (ABD FPL) program once the state pays the individual’s Medicare Part B premiums. The income disregard would disregard from an individual’s income the amount of such individual’s incurred Medicare Part B premium. The purpose of the legislation is to avoid any adverse impacts on beneficiaries.
Approval Date: October 21, 2020
Effective Date: December 2, 2020
Topics: Eligibility Program Administration

California
This SPA roll back the policy changes made effective by CA-19-0050 and restores the approved policy set forth in California’s State Plan prior to August 1, 2020. Policy changes made effective as of August 1, 2020 by CA-19-0050 cannot be implemented by California until a later date due to the COVID Public Health Emergency. This SPA package removes the Blind Federal Poverty Level and Aged & Disabled Federal Poverty Level income disregards of income up to 138% FPL added in 19-0050, and replaces them with California’s current approved income disregards for the Individuals Eligible for but not receiving Cash Assistance and the Age and Disability-Related Poverty Level coverage groups.
Approval Date: October 21, 2020
Effective Date: August 1, 2020
Topics: Program Administration

New York
Statewide formulary-drugs for Opioid dependence agents and Opioid antagonists
Approval Date: October 21, 2020
Effective Date: July 1, 2020
Topics: Program Administration