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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 3241 - 3250 of 15689

Minnesota
Makes changes to the staffing ratio during normal sleeping hours at inpatient psychiatric facilities.
Approval Date: September 8, 2022
Effective Date: July 1, 2022

Texas
This amendment clarified revisions to the inflation projection methodology for the Day Activity and Health Se1vices (DAHS), 1915 Home and Collllllunity-Based Se1vices-Adult Mental Health (HCBS-AMH), Inte1mediate Care Facilities for Individuals with an Intellectual Disability (ICF/IID), Nursing Facility (NF), and Primaiy
Home Cai·e (PHC) programs. A revision will also be made to the nursing wage inflation methodology, which will affect only the DAHS, HCBS-AMH, ICF/IID, and NF programs.
Approval Date: September 8, 2022
Effective Date: March 1, 2022
Topics: Home and community based services Reimbursement

New Hampshire
This amendment provides for reimbursement under single case agreements for inpatient hospital services, outpatient services and nursing facility services where there is a lack of existing New Hampshire enrolled providers able to provide the medically necessary specialized services.
Approval Date: September 8, 2022
Effective Date: May 17, 2022

West Virginia
To establish a targeted case management benefit for Medicaid eligible pregnant and post-partum individuals who are in the Drug Free Moms and Babies (DFMB) program.
Approval Date: September 6, 2022
Effective Date: June 9, 2022

Montana
The purpose of this amendment is to temporarily increase payment rates for fee for service state plan home and community based services through quarterly supplemental payments based upon a percentage of Medicaid allowable paid claims in order to maintain a stable workforce and preserve services during the declared public health emergency.
Approval Date: September 2, 2022
Effective Date: April 1, 2022
Topics: Disaster Relief Home and community based services Reimbursement

Missouri
This State Plan Amendment ensures that the Health Insurance Premium Payment (HIPP) Program in Missouri operates in the most efficient and cost-effective manner possible by eliminating areas where Medicaid may be paying for multiple premiums on behalf of the same participant.
Approval Date: September 1, 2022
Effective Date: January 1, 2023

Ohio
To update state plan language related to the coordination of benefits for hospital services and remove obsolete rules-based language that is no longer pertinent.
Approval Date: September 1, 2022
Effective Date: June 2, 2022

Kansas

Approves the reimbursement methodology for Dispensed As Written (DAW1) drugs.

Approval Date: September 1, 2022
Effective Date: June 1, 2022
Topics: National Average Drug Acquisition Cost (NADAC) Prescribed Drugs

Washington
Implement changes to payments to hospitals meeting certain criteria for Sole Community Hospitals (SCH). ESSB 5693 separated the
rates into two categories - one for Sole Community Hospitals (SCH), and one for SCHs taking single bed certifications (SBCs).
Approval Date: September 1, 2022
Effective Date: July 1, 2022
Topics: Financing & Reimbursement

Ohio
Updates pages for payment of Eyeglasses.
Approval Date: August 31, 2022
Effective Date: July 1, 2022
Topics: Financing & Reimbursement