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 2991 - 3000 of 15693

New Mexico
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is split out payment for pasteurized donor human milk in inpatient settings in order to track utilization.
Approval Date: November 14, 2022
Effective Date: July 1, 2022
Topics: Disaster Relief Financing & Reimbursement

Colorado

This Amendment updates the State Governor’s Designation Letter for who can sign state plan submissions for Colorado.

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

California
This SPA amends the definition of a Targeted Case Management (TCM) encounter to include the provision of TCM services appropriately provided face-to-face, as well as through video synchronous and audio-only synchronous telehealth interactions.
Approval Date: November 10, 2022
Effective Date: January 1, 2023

Louisiana
This SPA is to amend the provisions governing behavioral health rehabilitation services in order to update Community Psychiatric Support and Treatment (CPST) and Psychosocial Rehabilitation (PSR) services.
Approval Date: November 10, 2022
Effective Date: January 1, 2023

Ohio
Proposes to remove telehealth references from the state plan since the coverage provisions and payment rates for services delivered via telehealth are the same as services delivered face-to-face.
Approval Date: November 10, 2022
Effective Date: July 1, 2022

Arizona
Updates the state plan Nursing Facility (NF) rates.
Approval Date: November 10, 2022
Effective Date: October 1, 2022
Topics: Financing & Reimbursement

Arizona
Updates the state plan DRG rates.
Approval Date: November 10, 2022
Effective Date: October 1, 2022
Topics: Financing & Reimbursement

Indiana
This State Plan Amendment (SPA) looks to provide Medicaid coverage for eligible members to receive general pediatric vaccine counseling as part of EPSDT. Beginning with dates of service on or after September 1, 2022, stand-alone general pediatric vaccination counseling as part of the early and periodic screening, diagnostic, and treatment (EPSDT) benefit will be reimbursed under CPT 99401 with modifier EP per the fee schedule. This SPA also relocates payment for Ambulance Response and Treat-no-Transport Services for Emergency Medical Technicians (EMT's) under the direction of a physician.
Approval Date: November 10, 2022
Effective Date: September 1, 2022

Nebraska
SFY23 Nursing Facility Rates
Approval Date: November 10, 2022
Effective Date: July 1, 2022
Topics: Financing & Reimbursement

Pennsylvania
Continues supplemental payment funding for an additional class of acute care general hospitals to promote
quality medical services to individuals enrolled in the Pennsylvania Medical Assistance Program and provide financial relief to hospitals during the coronavirus pandemic.
Approval Date: November 10, 2022
Effective Date: October 9, 2022
Topics: Financing & Reimbursement