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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 5751 - 5760 of 15820

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

Louisiana
Amend the provisions governing reimbursement in the Pharmacy Benefits Management Program in order to add vaccines for adult recipients as a pharmacy benefit to provide an alternative location for these recipients to receive necessary vaccinations and immunizations.
Approval Date: April 24, 2020
Effective Date: March 20, 2020
Topics: Financing & Reimbursement

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

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
Adds Orange County (Group 4) to the existing Health Home Program with the population criterion of Serious Mental Illness (SMI) or Serious Emotional Disturbance (SED)
Approval Date: April 22, 2020
Effective Date: July 1, 2020

Colorado
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, and waive cost-sharing for testing services, testing-related services, and treatments for COVID-19.
Approval Date: April 21, 2020
Effective Date: March 1, 2020
Topics: Cost Sharing Disaster Relief Eligibility

Puerto Rico
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, impose less restrictive resource tests on certain eligibility groups, and to continue to consider residents who leave the Territory due to the disaster residents of the Territory.
Approval Date: April 21, 2020
Effective Date: March 1, 2020
Topics: Disaster Relief Eligibility