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 2911 - 2920 of 15750

Maryland
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 permit flexibility regarding preparation of eligibility applications in - person by caseworkers employed by the State of Maryland and navigators.
Approval Date: December 15, 2022
Effective Date: January 1, 2023
Topics: Disaster Relief Eligibility

California
This amendment is to comply with federal requirements on premium and cost sharing tracking and assessing copays on non-emergency use of services provided in emergency departments. This amendment proposes to eliminate copayments in the Medi-Cal program effective July 1, 2022. 
Approval Date: December 15, 2022
Effective Date: July 1, 2022

Kentucky
Proposes to implement changes to the Children's Advocacy Center’s services and reimbursements.
Approval Date: December 15, 2022
Effective Date: January 1, 2023
Topics: Coverage and Reimbursement

New York
Proposes to establish and authorize payment for Nutrition Services provided to children/youth by providers licensed under Article 29-I. Nutrition services are already reimbursed by providers under Article 25 and 28. This clarifies coverage under EPSDT in a statewide, comparable manner.
Approval Date: December 15, 2022
Effective Date: July 1, 2022

Montana
This amendment revises Rehabilitation services coverage and payment to enhance the continuum of care. The state has added a new service to the mental health and substance use disorder treatment continuum of care, identified the component services that are available under larger "umbrella" services, and updated practitioner/provider qualifications.
Approval Date: December 15, 2022
Effective Date: October 1, 2022
Topics: Coverage and Reimbursement

Wisconsin
This SPA will disregard Guaranteed Income Funds from a one-year pilot program for several non-MAGI eligibility groups.
Approval Date: December 15, 2022
Effective Date: July 1, 2022

Wisconsin
Description: This SPA expands coverage to Children born to persons eligible for CHIP or the 1115 BadgerCare Reform waiver at the tome of birth.
Approval Date: December 15, 2022
Effective Date: July 1, 2022

Montana

This SPA proposes to increase the
professional dispensing fee to $15.73 for pharmacies with an annual prescription volume between 0 and 39,999 prescriptions; $13.62 for pharmacies with an annual prescription volume between 40,000 and 69,999; or $11.52 for pharmacies with an annual prescription volume greater than or equal to 70,000.

Approval Date: December 15, 2022
Effective Date: July 1, 2022
Topics: Professional Dispensing Fee Reimbursement

Connecticut
This amendment looks to increase the minimum Community Spouse Protected Amount (CSPA) for institutionalized individuals.
Approval Date: December 15, 2022
Effective Date: July 1, 2022
Topics: Program Administration

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