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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 5621 - 5630 of 15693

Washington
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow cover the new optional group for COVID testing; apply less strict resource and income methods when determining eligibility for certain individuals; consider individuals evacuated from the state due to the emergency to continue to be residents; provide medical coverage to non-residents who are quarantined in the state due to COVID-19; allow hospitals to make presumptive eligibility decisions for certain individuals; suspend enrollment fees and premiums for all individuals; expand telehealth; add certain benefits and increase some payment rates related to the COVID-19 national emergency.
Approval Date: April 24, 2020
Effective Date: March 1, 2020
Topics: Benefits Cost Sharing Disaster Relief Eligibility Financing & Reimbursement Premiums Prescription Drugs

New Mexico
This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to designate qualified entities to determine presumptive eligibility, and attest that the state does not intend to impose co-pays upon beneficiaries for COVID-19 related services.
Approval Date: April 24, 2020
Effective Date: April 1, 2020
Topics: Cost Sharing Disaster Relief Eligibility

New Mexico
increases the payment rates for vision screening codes
Approval Date: April 24, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

New York
Updates existing policy on the minimum utilization percentage and therapy leave days for psychiatric residential treatment facilities (PRTF).
Approval Date: April 24, 2020
Effective Date: July 1, 2018
Topics: Current State Plan Program Administration

Michigan
Proposes to reimburse for psychiatric diagnostic evaluations services for beneficiaries under 21 years of age at 100% of the annual Medicare rates published each year.
Approval Date: April 24, 2020
Effective Date: February 1, 2020
Topics: Financing & Reimbursement

Arkansas
Establishes new provider qualification requirements for targeted case managers in ARChoices Personal Care.
Approval Date: April 23, 2020
Effective Date: July 1, 2020
Topics: Current State Plan Program Administration

California
Adjusts the Medi-Cal Fee-for-Service (FFS) reimbursement rates for Durable Medical Equipment (DME) services using the Medicare rural fee schedule for DME, Prosthetics, Orthotics, and Supplies
Approval Date: April 23, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

New Hampshire
Updates the allowance for a 3.1% increase to Home and Community Based Care for High Risk Children with Severe Emotional Disturbance rates
Approval Date: April 23, 2020
Effective Date: January 1, 2020
Topics: Benefits Financing & Reimbursement Program Administration

California
requests a two-year extension of the previously approved exception to renew the Recovery Audit Contractor (RAC)
Approval Date: April 23, 2020
Effective Date: February 1, 2020

New Mexico
increases the payment rates for Long-Acting Reversible Contraception (LARC) administration and insertion codes effective January 1, 2020
Approval Date: April 23, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement