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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 3001 - 3010 of 15690

Missouri
Allows for a rebase of the Nonstate-Operated Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/11O) services
Approval Date: November 10, 2022
Effective Date: October 1, 2022
Topics: Financing & Reimbursement

Kentucky
Changes to the intermediate care facility for individual s with an intellectual disability, dually-licensed pediatric fac ili ty, institution for mental diseases, or a nursing facility with an all-inclusive rate unit reimbursement language in its State Plan
Approval Date: November 10, 2022
Effective Date: August 1, 2022

California
This SPA amends the definition of a Targeted Case Management (TCM) encounter to include the provision of TCM services appropriately provided face-to-face, as well as through video synchronous and audio-only synchronous telehealth interactions.
Approval Date: November 10, 2022
Effective Date: January 1, 2023

Illinois
This amendment authorizes pharmacists to provide counseling regarding hormonal contraceptives.
Approval Date: November 9, 2022
Effective Date: August 1, 2022
Topics: Coverage and Reimbursement

Delaware
Updates Delaware Medicaid State Plan Targeted Case Management (TCM) services to align provider qualifications and reimbursement.
Approval Date: November 9, 2022
Effective Date: July 1, 2022

Colorado
Adds prospective payments and gainsharing to the physician services Alternative Payment Model (APM) for non-Federally Qualified Health Center primary care medical providers.
Approval Date: November 9, 2022
Effective Date: January 1, 2022
Topics: Financing & Reimbursement

South Carolina
Updating nursing facility payment rates effective October 1, 2022 as well as the "Lost COVID Occupancy" payment methodology.
Approval Date: November 9, 2022
Effective Date: October 1, 2022
Topics: Financing & Reimbursement

Texas
Updates the fee schedule for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) and Vision Care Services.
Approval Date: November 9, 2022
Effective Date: September 1, 2022

West Virginia
Ambulance Ground Transportation Rates Increased to 100% of Medicare
Approval Date: November 9, 2022
Effective Date: July 1, 2022

Oregon
This SPA increased the fee-for-service reimbursement behavioral health rates by an aggregate average of 30 percent and also removed interpreter services from this page as interpreter services are approved for all programs under TN 22-0009.
Approval Date: November 9, 2022
Effective Date: July 1, 2022