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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 3381 - 3390 of 15689

New Hampshire
NH entered into a contract with a new broker for non-emergency medical transportation. This amendment is being submitted to specify in the State Plan that effective May 1, 2022, the state changed the reimbursement methodology from a per member per month risk capitated rate.
Approval Date: July 8, 2022
Effective Date: May 1, 2022

Nevada
This Nevada SPA 21-0012 was approved on July 7, 2022 inadvertently omitted Attachment 4.19-B, Pages 3a and 3a (Continued). We have attached these pages as well as a revised CMS-179 that reflects their inclusion in the approval. No other SPA pages are affected, and the original SPA approval date of July 7, 2022 and effective date of August 27, 2021 remain in effect for the entire SPA, including the two omitted pages.
Approval Date: July 7, 2022
Effective Date: August 27, 2021
Topics: Coverage and Reimbursement

Illinois
This amendment complies with the requirements for assurance of Medicaid coverage for non-emergency medically-related transportation in accordance with Section 209 of the Consolidated Appropriations Act of 2021.
Approval Date: July 7, 2022
Effective Date: December 27, 2021

Maryland
To update State Plan language regarding the EPSDT program, including eligible provider types, clarifying limitations to dental and audiological services, and removing references to the 504 Written Individualized Program.
Approval Date: July 7, 2022
Effective Date: April 1, 2022

Kentucky
Implementing a new reimbursement system for price-based nursing facilities participating in the Medicaid program.
Approval Date: July 7, 2022
Effective Date: July 1, 2022

Illinois
Adjust the reimbursement methodology for nursing facilities to align with the Medicare Patient Driven Payment Model (PDPM), incentivize quality care and staffing levels, and include a $70 million annual quality incentive payment tied to Long Stay STAR ratings.
Approval Date: July 7, 2022
Effective Date: July 1, 2022

Colorado
upgrades the version of Enhanced Ambulatory Patient Group (EAPGs) in use for calculation of fee for service outpatient hospital payment in order to align payment with modern outpatient healthcare delivery standards.
Approval Date: July 6, 2022
Effective Date: January 1, 2022

California
Updates the payment methodologies for the Outpatient Disproportionate Share Hospital (OP DSH) and Outpatient Small and Rural Hospital (OP SRH) supplemental reimbursement programs.
Approval Date: July 5, 2022
Effective Date: July 1, 2022

Missouri
Provides additional reimbursement to nursing facilities for increases in costs associated with staffing, supplies, social distancing standards, and other factors due to the COVID-19 national emergency.
Approval Date: July 5, 2022
Effective Date: July 1, 2022

Oklahoma

Established the Ambulance Service Provider Access Payment Program.

Approval Date: July 5, 2022
Effective Date: January 1, 2022