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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 2871 - 2880 of 15690

Colorado
This plan amendment carves select outpatient hospital opioid antagonist drugs, which are otherwise compensated through the Enhanced Ambulatory Patient Groups (EAPG) payment methodology, out of the EAPG methodology and reimburses them at the lower of billed charges or the fee schedule rate.
Approval Date: December 15, 2022
Effective Date: July 8, 2022

Rhode Island
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to waive any signature requirements for the dispensing of drugs during the Public Health Emergency.
Approval Date: December 14, 2022
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief

Tennessee
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to waive any signature requirements related to the dispensing of prescription drugs during the COVID-19 public health emergency (PHE).
Approval Date: December 14, 2022
Effective Date: March 13, 2020
Topics: Benefits Disaster Relief

Virgin Islands
Increases the ABD resource limit for ABD and Medically Needy populations from $1,500 per person to $10,000.
Approval Date: December 14, 2022
Effective Date: July 1, 2022

Virgin Islands
Brings the territory into compliance with the requirements of Section 2302 of the Affordable Care Act (ACA) (concurrent care for children).
Approval Date: December 14, 2022
Effective Date: August 9, 2022

Kansas
This State Plan Amendment increases reimbursement rates for low profile G-tubes and accompanying extension sets.
Approval Date: December 14, 2022
Effective Date: August 26, 2022

Arkansas
This SPA increases the Long-Acting Reversible Contraceptives (LARCs) to include the IUD and contraceptive implants by 6%.
Approval Date: December 14, 2022
Effective Date: January 1, 2023

Massachusetts
This plan amendment revises the payment rates for adult foster care (AFC) services, inclusive of group adult foster care (GAFC) services.
Approval Date: December 14, 2022
Effective Date: July 1, 2022

Massachusetts
This plan amendment revises the payment rates for personal care attendant (PCA).
Approval Date: December 14, 2022
Effective Date: July 1, 2022

California
This SPA amends the reimbursement methodology for clinical laboratory or laboratory services.
Approval Date: December 14, 2022
Effective Date: July 1, 2021