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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 3271 - 3280 of 15693

Florida
Updates the inpatient hospital reimbursement methodology for Indirect Graduate Medical Education (IME) payments to specify calculation of annual IME payments based on the most recently filed and available cost reports. The amendment also adds inpatient state directed payment arrangements allowed under 42 CFR 438.6(c) approved pre-prints and made through managed care plans (“Inpatient DRG Enhanced Rate”) to the calculation of annual IME payments.
Approval Date: August 23, 2022
Effective Date: March 30, 2022

Oklahoma
Updates and clarifies the frequency and method for re-basing Certified Community Behavioral Health (CCBH) Prospective Payment System (PPS) rates based on cost reports.
Approval Date: August 23, 2022
Effective Date: October 1, 2021
Topics: Financing & Reimbursement

New Hampshire
Revises the quarterly nursing home supplemental payment, also known as MQIP, for dates of service in the quarter ending June 30, 2022.
Approval Date: August 23, 2022
Effective Date: April 1, 2022

Indiana
Makes a change to the State Plan to revise Medicaid reimbursement for inpatient or outpatient hospital services provided by a children's hospital located in a state bordering Indiana.
Approval Date: August 23, 2022
Effective Date: June 1, 2022

Massachusetts
This amendment updates the state plan to waive the Recovery Audit Contractor (RAC) Program.
Approval Date: August 23, 2022
Effective Date: April 1, 2022
Topics: Program Administration

Wisconsin
This State Plan Amendment adds the Collaborative Care Model as a reimbursable service under the Medical Assistance (MA) program under physician services.
Approval Date: August 23, 2022
Effective Date: June 1, 2022

District of Columbia
updates the Physician Supplement Payment for Fiscal Year 2023.
Approval Date: August 22, 2022
Effective Date: October 1, 2022
Topics: Financing & Reimbursement

Kansas
This amendment adds Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) reimbursement rates for periodontal
maintenance and for the use of prefabricated porcelain and ceramic crowns on primary teeth, as well as for the repair of crowns on primary teeth. It also increases ESPDT pediatrician reimbursement rates.
Approval Date: August 22, 2022
Effective Date: July 1, 2022
Topics: Coverage and Reimbursement

Rhode Island
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 Disaster Relief provision to expand medication prior authorizations to allow renewal automatically without clinical review or time/quantity extensions.
Approval Date: August 19, 2022
Effective Date: April 1, 2022
Topics: Benefits Disaster Relief

Rhode Island
The amendment seeks to update Rhode Island’s Medicaid State Plan to provide assurance of coverage of COVID-19 vaccine administration, testing, treatment, and stand-alone vaccine counseling for children.
Approval Date: August 19, 2022
Effective Date: March 11, 2021
Topics: Benefits Reimbursement