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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 2611 - 2620 of 15696

Northern Mariana Islands
This amendment establishes compliance with the mandatory coverage and reimbursement of routine patient costs furnished in connection with participation in qualifying clinical trials under Section 1905(gg) of the Social Security Act.
Approval Date: March 8, 2023
Effective Date: January 1, 2023
Topics: Coverage and Reimbursement

Montana
This SPA proposes to remove the reference to Average Sales Price (ASP) + 6% on the Pharmacy reimbursement State Plan page; modify language on Pharmacy coverage pages to reflect coverage of select over-the-counter medications.; and remove the reference of vaccines and agents used for cosmetic purposes from Pharmacy coverage pages.
Approval Date: March 8, 2023
Effective Date: November 2, 2022
Topics: Prescribed Drugs Reimbursement

Pennsylvania

This SPA proposes to amend the pharmacy pages provisions regarding coverage of agents when used for symptomatic relief of cough and colds.

Approval Date: March 8, 2023
Effective Date: May 12, 2023
Topics: Coverage Covered Outpatient Drug Prescription Drugs

New Hampshire
This plan updates Private Non-Medical Institution (PNMI) reimbursement methodology.
Approval Date: March 7, 2023
Effective Date: February 18, 2022

Oregon
This amendment is to continue flexibilities granted in the Oregon 1915(j) Self-Directed Personal Assistance Services beyond the end of the COVID-19 Public Health Emergency (PHE).
Approval Date: March 6, 2023
Effective Date: May 12, 2023
Topics: Home and community based services

Kentucky
Adds coverage and reimbursement for Community Health Workers to the Medicaid State Plan.
Approval Date: March 6, 2023
Effective Date: July 1, 2023

Connecticut
This amendment looks to implement updates to physician, medical clinic, DME/MEDS fee schedules, increase rates for Etonogestrel implant system LARC devices, add a code for monkeypox testing to select fee schedules, and update DME/MEDS fee schedule.  This SPA also removes age limits for naturopath coverage and expands coverage for behavioral health clinicians to include associate practitioners.
Approval Date: March 6, 2023
Effective Date: October 1, 2022
Topics: Coverage Program Administration Reimbursement

Connecticut
This amendment expands the coverage and payment for the use of Silver Diamine Fluoride (SDF) to all HUSKY Health (Medicaid) children and adults who receive dental services.
Approval Date: March 6, 2023
Effective Date: November 1, 2022
Topics: Coverage and Reimbursement Dental

California
This SPA updates the the Current Dental Terminology (CDT) dental codes to the CDT 2023 (“CDT-23”) code set and the supplemental payment amount for eligible codes.
Approval Date: March 3, 2023
Effective Date: April 1, 2023

Alabama
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to waive the signature requirements for the dispensing of drugs during the Covid-19 Public Health Emergency.
Approval Date: March 3, 2023
Effective Date: March 1, 2020
Topics: Disaster Relief Prescribed Drugs