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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 3371 - 3380 of 15689

Colorado
Updates the reimbursement methodology for the state’s Hospital Back-Up Program. Specifically, rate setting will be based on the level of care needs of members, prospectively.
Approval Date: July 18, 2022
Effective Date: October 1, 2021

Massachusetts
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to revise the payment method for Chronic Disease and Rehabilitation hospitals effective.
Approval Date: July 15, 2022
Effective Date: October 1, 2021
Topics: Disaster Relief Financing & Reimbursement

Wyoming
This SPA eliminates the “deprivation” requirement relating to dependent children living with individuals who seek Medicaid on the basis or being parents and other caretaker relatives.
Approval Date: July 15, 2022
Effective Date: April 1, 2022

Nebraska
This amendment is part of the Alternative Benefit Plan (ABP) required for the adult population for Medicaid expansion. Specifically, this ABP is for the Consolidated Appropriations Act (CAA) coverage of routine costs associated with qualifying clinical trials.
Approval Date: July 15, 2022
Effective Date: January 1, 2022

Illinois
reimbursement methodology complies with applicable requirements
Approval Date: July 15, 2022
Effective Date: April 1, 2022

Montana
This amendment addresses third party liability and related Medicaid payments associated with prenatal care, preventive pediatric services, and medical child support.
Approval Date: July 13, 2022
Effective Date: April 1, 2022

Wyoming
This amendment is to comply with mandatory Medicaid coverage of routine patient costs furnished in connection with participation in qualifying clinical trials.   
Approval Date: July 13, 2022
Effective Date: January 1, 2022
Topics: Coverage and Reimbursement

South Dakota
The SPA updates the state's coverage of organ transplant to more accurately reflect current state practice.
Approval Date: July 12, 2022
Effective Date: May 1, 2022

West Virginia
To update third-party liability requirements.
Approval Date: July 11, 2022
Effective Date: April 1, 2022

Ohio
To update Ohio’s Alternative Benefit Plan by revising the language regarding the interplay between the fee-for-service and managed care delivery systems for the adult expansion group to more accurately reflect current policy.
Approval Date: July 11, 2022
Effective Date: April 7, 2022
Topics: Alternative Benefit Plan