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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 6091 - 6100 of 15826

New York
Authorizes temporary rate adjustments for the outpatient services of specified essential community hospital providers
Approval Date: December 20, 2019
Effective Date: July 1, 2019
Topics: Financing & Reimbursement

California
This State Plan Amendment is required to implement state Senate Bill (SB) 104 (2019). SB 104 increases the Blind Federal Poverty Level (FPL) and the Aged and Disabled FPL program income limits by increasing the income disregard to all countable income above the SSI/SSP payment standard up to 138% of FPL for the Blind FPL program and 100% up to 138% FPL for the Aged and Disabled FPL program. The income disregard is applied after all other exclusions and disregards.
Approval Date: December 20, 2019
Effective Date: August 1, 2020
Topics: Eligibility Program Administration

Iowa
Amends ABP 5 to add additional benefits under the Basic Dental Package and to add Denture Benefits.
Approval Date: December 19, 2019
Effective Date: August 30, 2019
Topics: Dental Program Administration

Tennessee
changes to Hospital Presumptive Eligibility (HPE), modifications to Presumptive Eligibility (PE) for Pregnant Women, the Eligibility Process Reviewable Unit, and the state’s election to end the option to provide Presumptive Eligibility to children under age 1.
Approval Date: December 19, 2019
Effective Date: March 18, 2019

New York
APG updates to Hospital Outpatient (FMAP=50%)
Approval Date: December 19, 2019
Effective Date: July 1, 2019
Topics: Financing & Reimbursement

Oklahoma
Proposes to increase the nursing facility pool amounts, base rate components for nursing facilities serving adults and AIDS patients.
Approval Date: December 19, 2019
Effective Date: July 1, 2019
Topics: Financing & Reimbursement

Oklahoma
Five (5) percent rate increase for the pharmacy professional dispensing fee.
Approval Date: December 19, 2019
Effective Date: October 1, 2019
Topics: Financing & Reimbursement Prescription Drugs

District of Columbia

This amendment will authorize the District to reimburse the Medicaid RACs up to the highest contingency fee used under the Medicare RAC Program.

Approval Date: December 19, 2019
Effective Date: January 1, 2020
Topics: Program Administration

Minnesota
Revises methodologies and standards for Inpatient Hospital rates. Specifically, this amendment:
. Reduces the rate to reflect the change in the MinnesotaCare provider tax on January 1,2020.
. Adds a policy adjustment factor for specialty mental health services, and revises the policy adjustment factor for: burns; pre-major diagnostic category; transplants; and trauma.
. Revises the charge limit.
. Revises the base year to 2016 for hospital costs.
Approval Date: December 18, 2019
Effective Date: July 1, 2019
Topics: Financing & Reimbursement

Kansas
re-bases Nursing Facility and Nursing Facility for Mental Health payment rates for state fiscal year 2020. Also updates charts and exhibits with the State plan that demonstrate the revised factors and limits applicable to the rate period beginning with SFY 2020.
Approval Date: December 18, 2019
Effective Date: July 1, 2019
Topics: Financing & Reimbursement