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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 2761 - 2770 of 15696

Hawaii
This SPA clarifies that all vaccine administration services are paid at a rate of $4.00 unless otherwise specified, regardless of billing code. This SPA also sets the state's Monkey Pox vaccine administration rate equal to the Medicare geographic rate for COVID-19 vaccine administration, updating the effective date to 10/15/22 and the fee schedule links for Evaluation & Management Services (E&M) and vaccine administration.
Approval Date: January 24, 2023
Effective Date: October 15, 2022

Louisiana
The purpose of this SPA is to establish the criteria for an acute care hospital to qualify as an urban metropolitan statistical area (MSA) facility in the New Orleans area and establish the reimbursement methodology for the provision of inpatient services.
Approval Date: January 23, 2023
Effective Date: October 11, 2022

Michigan
 updates language to reflect the adoption of the American Academy of Pediatric Dentistry Recommendations for Pediatric Oral Health Assessment, Preventive Services, and Anticipatory Guidance/ Counseling schedule as a dental-specific periodicity schedule for children up to age 21 under the EPSDT requirement defined in section 1905(r) of the Social Security Act.
Approval Date: January 23, 2023
Effective Date: January 1, 2023

Pennsylvania
This amendment proposes to continue DSH payments to Medical Assistance enrolled and qualifying trauma centers. Additionally, it’s updating the qualifying criteria and payment methodology to clarify how new accredited trauma centers and hospitals seeking trauma center accreditation can qualify and be paid.
Approval Date: January 23, 2023
Effective Date: December 11, 2022

New York
This amendment proposes to assist nursing facilities by providing a temporary rate adjustment for facilities that are under closure, merger, consolidation, acquisition, or restructuring.
Approval Date: January 23, 2023
Effective Date: January 1, 2022

Pennsylvania
This amendment proposes to amend qualifying criteria and payment methodology for DSH and outpatient hospitals for Medical Assistance and qualifying emergency departments in acute care general hospitals.
Approval Date: January 23, 2023
Effective Date: December 4, 2022

Kentucky
CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency.  The purpose of this amendment is to disregard any excess resources for LTC members as of the month the PHE ends and for 90 days thereafter and increase its PE period to application month to following months or until a regular Medicaid application has been submitted and determination made.
Approval Date: January 20, 2023
Effective Date: January 12, 2023
Topics: Disaster Relief Eligibility

Mississippi

This SPA is being submitted to comply with the ARP requirements for coverage of COVID-19 treatment or for a condition that may seriously complicate the treatment of COVID-19.

Approval Date: January 20, 2023
Effective Date: March 11, 2021
Topics: Benefits Disaster Relief Reimbursement

Massachusetts
This amendment adds provider qualifications to indicate that private duty
nursing services may be provided by either independent nurses or agency-based providers.
Approval Date: January 20, 2023
Effective Date: October 1, 2022

Delaware
This amendment amends Delaware State Plan to assure coverage of routine patient costs associated with participation in qualifying clinical trials.
Approval Date: January 20, 2023
Effective Date: October 1, 2022