U.S. flag

An official website of the United States government

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 6111 - 6120 of 15826

Colorado
Adds an Alternative Payment Model (APM) to the Physician Service reimbursement page in Attachment 4. 19- 13: Methods and Standards for
Establishing Payment Rates
Approval Date: December 17, 2019
Effective Date: October 1, 2019
Topics: Financing & Reimbursement

Connecticut
incorporates various Healthcare Common Procedure Coding System (HCPCS) updates to the Physician Office & Outpatient, Physician-Radiology, Physician-Surgery, Psychology and Autism Spectrum Disorder Services fee schedules. In accordance with section 12 of Attachment 4.19-B of the State Plan, this SPA also updates the
physician fee schedule and incorporates the required annual update for reimbursement of physician administered drugs, immune globulins, vaccines and toxoids.
Approval Date: December 17, 2019
Effective Date: January 1, 2019
Topics: Financing & Reimbursement

Colorado
modifies the reimbursement methodology for long-acting reversible contraceptive ( LARC) devices, inserted following delivery, in an inpatient hospital setting.
Approval Date: December 17, 2019
Effective Date: January 1, 2019
Topics: Financing & Reimbursement

Montana
Reimbursement update for Inpatient Hospital APR-DRG
Approval Date: December 17, 2019
Effective Date: October 1, 2019
Topics: Financing & Reimbursement

Missouri
This SPA describes the methodology used by the state for determining the appropriate FMAP rates, including the increased FMAP rates, available under the provisions of the Affordable Care Act applicable for the medical assistance expenditures under the Medicaid program associated with enrollees in the new adult group adopted by the state and described in 42 CFR 435.119. 
Approval Date: December 17, 2019
Effective Date: July 1, 2021

Indiana
makes changes to the Medicaid State Plan in the event of a decrease in Indiana's federal DSH allotment.
Approval Date: December 16, 2019
Effective Date: October 1, 2019
Topics: Financing & Reimbursement

New York
Applies changes to the state’s rehabilitation benefit by implementing targeted services for individuals with intellectual and/or developmental disabilities who have significant behavioral or mental health needs
 
Approval Date: December 16, 2019
Effective Date: January 1, 2020
Topics: Benefits Current State Plan

Minnesota
Revising payment rates for PCA services.
 
Approval Date: December 16, 2019
Effective Date: July 1, 2019
Topics: Financing & Reimbursement

Ohio
Coverage & Limitations and Payment for Services: Behavioral Health
 
Approval Date: December 16, 2019
Effective Date: August 1, 2019
Topics: Financing & Reimbursement

North Dakota
Reimbursement update for ICF Additional Criteria
Approval Date: December 16, 2019
Effective Date: July 1, 2019
Topics: Financing & Reimbursement