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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 2661 - 2670 of 15693

Mississippi
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 Private Duty Nursing (PDN) and Prescribed Pediatric Extended Care (PPEC) services.
Approval Date: February 24, 2023
Effective Date: October 1, 2022
Topics: Disaster Relief Reimbursement

Oregon
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to extend the 5% increase in payment rates for ODDS services and settings for the period 1/1/23 through 6/30/23 or until the end of the PHE which ever is first.
Approval Date: February 24, 2023
Effective Date: January 1, 2023
Topics: Disaster Relief Reimbursement

Colorado
This plan amendment revises the methods and standards for establishing payment rates for hospice services.
Approval Date: February 24, 2023
Effective Date: October 1, 2022

Iowa
This amendment adds registered behavior technicians to the list of eligible providers to provide Applied Behavior Analysis (ABA) services.
Approval Date: February 24, 2023
Effective Date: October 1, 2022

Indiana
This amendment updates the alternative benefit plan to include coverage requirements for routine patient costs associated with participation in clinical trials for the Healthy Indiana Plan (HIP) Plus group.
Approval Date: February 24, 2023
Effective Date: October 1, 2022
Topics: Alternative Benefit Plan

California
This SPA is adding mandatory benefits regarding coverage of COVID-19 vaccines, testing, and treatments to the Medicaid State Plan. The state submitted the completed ARP preprints for COVID Vaccines, Testing, and Treatment.
Approval Date: February 24, 2023
Effective Date: March 11, 2021
Topics: Benefits Disaster Relief Reimbursement

California
This SPA adjusts the reimbursement rate for the Prenatal Screening (PNS) cell-free DNA (cfDNA) Screening code 81420.
Approval Date: February 24, 2023
Effective Date: October 1, 2022

California
This SPA adjusts the reimbursement rate for the Prenatal Screening (PNS) cell-free DNA (cfDNA) Screening code 81420.
Approval Date: February 24, 2023
Effective Date: October 1, 2022

Mississippi
State Plan Amendment (SPA) 22-0025 was submitted to allow the Division of Medicaid (DOM) to update the disproportionate share hospital (DSH) redistribution methodology following annual audits to allow
all providers who were underpaid to receive additional payment.
Approval Date: February 24, 2023
Effective Date: October 1, 2022

Louisiana
The purpose of this SPA is to allow reimbursement, outside of the inpatient hospital per diem, for genetic testing of critically ill infants.
Approval Date: February 24, 2023
Effective Date: January 1, 2023