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 3081 - 3090 of 15689

District of Columbia
This SPA removed the fifteen (15) day limit that an individual identified for inclusion in the Pharmacy Lock-in Program has to submit a request for a hearing on the lock-in decision from the state plan pages.
Approval Date: October 21, 2022
Effective Date: October 1, 2022

Oregon
This amendment is to add two additional provider types, Licensed Dietician, and Licensed Genetic Counselor, to the Other Licensed Practitioner section of the State Plan.
Approval Date: October 21, 2022
Effective Date: July 1, 2022
Topics: Other Licensed Practitioners

South Carolina
Implements a rate increase for Children's Personal Care, Enhanced Nursing, Registered Nurse (RN) and Licensed Practical Nurse (LPN).
Approval Date: October 20, 2022
Effective Date: July 1, 2022
Topics: Financing & Reimbursement

Illinois
The state elect its option to provide 12 months of postpartum Medicaid coverage to individuals who were pregnant when enrolled in Medicaid.
Approval Date: October 20, 2022
Effective Date: July 1, 2022

District of Columbia
will allow pharmacies to receive reimbursement for the administration fee associated with providing VFC program vaccine and immunizations.
Approval Date: October 19, 2022
Effective Date: September 1, 2022

Maryland
Implements an 8% rate increase for the Developmental Disabilities Administration Targeted Case Management (DDA TCM) program. In addition, a temporary 10 % rate increase for DDA TCM services using 100 % 9817 generated savings funds for dates of service 10/1/22 through 12/31/22 and on January 1, 2023, the rates will revert back to the rates approved on 07/01/2022.
Approval Date: October 19, 2022
Effective Date: July 1, 2022
Topics: Financing & Reimbursement

Vermont
This amendment adds mandatory coverage of routine patient costs in qualifying clinical trials per the Consolidated Appropriations Act of 2021 to the state's ABP.
Approval Date: October 14, 2022
Effective Date: January 1, 2022

Vermont

 This amendment updates the Recovery Audit Contractor (RAC) Program exemption date.

Approval Date: October 14, 2022
Effective Date: July 1, 2022
Topics: Program Administration

Kansas
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to rescind the authorities regarding Presumptive Eligibility (PE) authorized in sections B.1, B.2, and B.3 of DR SPA KS-20-0012. This will revert the State back to the practice of one PE period for parents or caretaker relatives, children, former foster care children; one PE period per pregnancy per a 12-month period; remove the state as a qualified entity; and eliminate the ability for qualified providers to determine eligibility for Parents/Caretaker Relatives and Former Foster Care Children.
Approval Date: October 14, 2022
Effective Date: July 1, 2022
Topics: Disaster Relief Eligibility

Pennsylvania
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to provide one-time lump sum supplemental payments to non-emergency medical transportation (NEMT) providers for the rate year beginning July 1, 2021 and ending June 30, 2022.
Approval Date: October 14, 2022
Effective Date: July 1, 2021
Topics: Disaster Relief Reimbursement