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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 5641 - 5650 of 15693

Minnesota

This SPA allows the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271).

Approval Date: April 20, 2020
Effective Date: October 1, 2019
Topics: Drug Utilization Review (DUR)

Louisiana
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing, suspend all cost sharing, extend all prior authorization by automatic renewal without clinical review or time/quantity extensions, expand telehealth, adjust prior authorizations for medications, and increase certain payment rates.
Approval Date: April 20, 2020
Effective Date: March 1, 2020
Topics: Benefits Cost Sharing Disaster Relief Eligibility Financing & Reimbursement Prescription Drugs

Minnesota
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 provider contact with Medicaid beneficiaries to be conducted via telehealth for Targeted Case Management Services.
Approval Date: April 20, 2020
Effective Date: March 19, 2020
Topics: Benefits Disaster Relief

Minnesota
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 the following rehabilitative providers to provide services via telehealth, including via telephone: Alcohol and drug counselors, alcohol and drug counselor temps, recovery peers, student interns, mental health certified peer specialists, mental health certified family peer specialists, mental health rehabilitation workers in ARMHS, and mental health behavioral aides operating in CTSS programs.
Approval Date: April 20, 2020
Effective Date: March 19, 2020
Topics: Benefits Disaster Relief

California
Updates the rates for Radiological services to pay no more than 80% of the corresponding Medicare Physician Fee Schedule rate
Approval Date: April 20, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Rhode Island
Update the Medically Needy Income Levels and to also update the standards for the Optional State Supplement Beneficiaries eligibility group
Approval Date: April 18, 2020
Effective Date: January 1, 2020
Topics: Current State Plan Eligibility Program Administration

Wisconsin
Modifies the income limits for the Optional State Supplement Beneficiaries to reflect the Social Security Cost of Living Adjustment (COLA).
Approval Date: April 18, 2020
Effective Date: January 1, 2020

Guam
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to Increase payment rates for Inpatient and Outpatient Hospital Services, Physician Services, Home Health Services, Clinic Services for Physicians Services and Other Practitioner’s Services during the Public Health Emergency Period.
Approval Date: April 17, 2020
Effective Date: April 1, 2020
Topics: Disaster Relief Financing & Reimbursement

Maryland
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to suspend certain premium payments required under Maryland’s Medicaid state plan.
Approval Date: April 17, 2020
Effective Date: March 1, 2020
Topics: Cost Sharing Disaster Relief

Washington
Updates the allowance for a 10% increase to the Behavioral Health Services (BHR) rates
Approval Date: April 17, 2020
Effective Date: January 11, 2020
Topics: Financing & Reimbursement