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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 2631 - 2640 of 15696

New Hampshire
This amendment proposes to provide a comprehensive adult dental benefit that includes diagnostic, preventive, limited periodontal, restorative, and oral surgery services for all Medicaid eligible adults age 21 and older within the Alternative Benefit Plan.
Approval Date: March 2, 2023
Effective Date: April 1, 2023
Topics: Alternative Benefit Plan Dental

North Dakota
This amendment amend the State Plan to update the minimum requirements for an assessment for personal care services.
Approval Date: March 2, 2023
Effective Date: October 1, 2022

Colorado
This plan amendment updates the physician services alternative payment model (APM) by changing the time-frame for eligible payments that qualify primary care medical providers (PCMP) for the APM, thereby, making the APM code set
timeline prospective and ongoing rather than tied to specific past dates, and pushing the 2021 APM rate adjustments
back from July 1, 2021 to October 1, 2021.
Approval Date: March 1, 2023
Effective Date: October 1, 2021

Oregon
This SPA has been submitted as related to the Inflation Reduction Act of 2022 temporary, 5-year increase for physician administered biosimilar drugs that will be paid Medicare's Average Sales Price (ASP) plus 8% (rather than plus 6%).
Approval Date: March 1, 2023
Effective Date: November 5, 2022
Topics: Physician Administered Drugs

Arizona
Describes the State’s Drug Utilization Review (DUR) program.
Approval Date: March 1, 2023
Effective Date: October 1, 2022
Topics: Drugs and Related Services

Illinois
This amendment provides for a rate adjustments for Outpatient Hospitals.
Approval Date: March 1, 2023
Effective Date: January 1, 2023

South Carolina
This SPA terminates the Hemophilia program arrangement with the South Carolina Department of Health and Environment Control Agency, at their request.
Approval Date: March 1, 2023
Effective Date: March 1, 2023

Texas
CMS is issuing a technical correction to the approval package for TX-22-0028. TX-22-0028 introduced Page 1 of Supplement 5 to attachment 4.19-B as a NEW page, however a previously approved SPA already added Page 1 of Supplement 5 to attachment 4.19-B. This technical correction will make the page added by TN 22-0028 Page 1-a.
Approval Date: March 1, 2023
Effective Date: September 1, 2022

Pennsylvania
Proposes to amend the pharmacy pages provisions to cover select non-legend drug products.
Approval Date: March 1, 2023
Effective Date: January 1, 2023

Indiana
This amendment updates the alternative benefit plan to include coverage requirements for routine patient costs associated with participation in clinical trials and extends the prescription drug supply limit from thirty (30) days to ninety (90) days for the Health Indiana Plan (HIP) Basic group.
Approval Date: March 1, 2023
Effective Date: October 1, 2022
Topics: Alternative Benefit Plan