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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 5561 - 5570 of 15820

Maine
Adds the Rural Hospital and Non-Rural Hospital definitions and updates hospital-based physician
reimbursement.
Approval Date: June 24, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Wisconsin
Modifies inpatient and outpatient reimbursement rates,including for critical care supplements, wage area adjustment indices for border status hospitals, cost-to-charge ratios, and outpatient access payments effective January 1, 2020
Approval Date: June 24, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Massachusetts
This plan amendment updates the payment methods used to determine rates of payment for outpatient
psychiatric rates.
Approval Date: June 24, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Massachusetts
Amends the Methods Used to Determine Rates of Payment for Vision Services
Approval Date: June 24, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Maine
Adds provisions for two legislatively mandated special supplemental wage allowances for nursing facilities services
 
Approval Date: June 24, 2020
Effective Date: April 1, 2020

Pennsylvania
Authorizes a supplemental payment to qualifying inpatient hospitals operating nursing schools
Approval Date: June 24, 2020
Effective Date: April 19, 2020
Topics: Current State Plan Financing & Reimbursement

Oklahoma
Separates and differentiates between services provided in a school setting under EPSDT versus those school-based services provided pursuant to an Individual Education Plan (IEP).
Approval Date: June 24, 2020
Effective Date: September 1, 2020
Topics: Benefits Current State Plan Program Administration

Iowa
This SPA seeks an exception to 42 CFR § 455.502, which requires each state to establish a Recovery Audit Contractor (RAC) program. The state seeks this exception because it is unable to procure a RAC vendor due to the small fee-for-service claims volume in the state.
Approval Date: June 24, 2020
Effective Date: July 1, 2020
Topics: Current State Plan Program Administration

New York
Workforce salary increase for qualified Office of Mental Health (OMH) licensed services. Additionally, this state plan amendment also considers labor costs resulting from statutorily required increases in the New York State minimum wage.
Approval Date: June 24, 2020
Effective Date: January 1, 2020
Topics: Program Administration

Montana
Updates fee schedule reimbursement as of March 1, 2020 for targeted case management services: (1) Youth with Serious Emotional Disturbance (SED, (2) Youth with SED in an Out-of-State PRTF, (3) Adults with Severe Disabling Mental Illness, (4) Substance Use
Disorders (SUD) – Youth and (5) SUD - Adult.
Approval Date: June 23, 2020
Effective Date: March 1, 2020
Topics: Financing & Reimbursement Rebate/Reimbursement Updates