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 6051 - 6060 of 15783

Iowa
Amends ABP 5 to add additional benefits under the Basic Dental Package and to add Denture Benefits.
Approval Date: December 19, 2019
Effective Date: August 30, 2019
Topics: Dental Program Administration

District of Columbia

This amendment will authorize the District to reimburse the Medicaid RACs up to the highest contingency fee used under the Medicare RAC Program.

Approval Date: December 19, 2019
Effective Date: January 1, 2020
Topics: Program Administration

Tennessee
changes to Hospital Presumptive Eligibility (HPE), modifications to Presumptive Eligibility (PE) for Pregnant Women, the Eligibility Process Reviewable Unit, and the state’s election to end the option to provide Presumptive Eligibility to children under age 1.
Approval Date: December 19, 2019
Effective Date: March 18, 2019

New York
APG updates to Hospital Outpatient (FMAP=50%)
Approval Date: December 19, 2019
Effective Date: July 1, 2019
Topics: Financing & Reimbursement

Oklahoma
Five (5) percent rate increase for the pharmacy professional dispensing fee.
Approval Date: December 19, 2019
Effective Date: October 1, 2019
Topics: Financing & Reimbursement Prescription Drugs

Iowa

Increases available services to members on the basic benefit package. In particular, denture related services were added. During the SFY19 it was revealed that members with dentures in the basic benefit tier did not have access to the needed services.

Approval Date: December 18, 2019
Effective Date: August 30, 2019

Minnesota

This amendment to the MInnesota Medicaid state plan:

  • Reduces the rate to reflect the change in the MinnesotaCare provider tax on January 1,2020.
  • Adds a policy adjustment factor for specialty mental health services, and revises the policy adjustment factor for: burns; pre-major diagnostic category; transplants; and trauma.
  • Revises the charge limit.
  • Revises the base year to 2016 for hospital costs.
Approval Date: December 18, 2019
Effective Date: July 1, 2019
Topics: Program Administration

Wisconsin
Amends methods of Implementation for Nursing Home Payment Rates
Approval Date: December 18, 2019
Effective Date: July 1, 2019
Topics: Program Administration

Minnesota
Revises methodologies and standards for Inpatient Hospital rates. Specifically, this amendment:
. Reduces the rate to reflect the change in the MinnesotaCare provider tax on January 1,2020.
. Adds a policy adjustment factor for specialty mental health services, and revises the policy adjustment factor for: burns; pre-major diagnostic category; transplants; and trauma.
. Revises the charge limit.
. Revises the base year to 2016 for hospital costs.
Approval Date: December 18, 2019
Effective Date: July 1, 2019
Topics: Financing & Reimbursement

Kansas
re-bases Nursing Facility and Nursing Facility for Mental Health payment rates for state fiscal year 2020. Also updates charts and exhibits with the State plan that demonstrate the revised factors and limits applicable to the rate period beginning with SFY 2020.
Approval Date: December 18, 2019
Effective Date: July 1, 2019
Topics: Financing & Reimbursement