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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 3391 - 3400 of 15815

Alabama
update cost effectiveness payment methodology from median to agency set criteria.
Approval Date: August 19, 2022
Effective Date: April 15, 2022
Topics: Program Administration 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

Pennsylvania
Approved a template that will authorize the state to enter into Outcome-Based Supplemental Rebate Agreements with drug manufacturers for drugs provided under the Medicaid program.
Approval Date: August 19, 2022
Effective Date: July 1, 2022

South Carolina
reimburse teaching physician providers under the Average Commercial Rate method under the Supplemental Teaching Physician (STP) Payment Program.
Approval Date: August 17, 2022
Effective Date: April 1, 2022

New York
Proposes to revise the State Plan to include routine patient costs for items and services furnished in connection with participation by Medicaid beneficiaries in qualifying clinical trials, including those beneficiaries enrolled in Alternative Benefit Plans, pursuant to the Center for Medicaid and CHIP Services requirements.
Approval Date: August 17, 2022
Effective Date: April 1, 2022

North Carolina
This State Plan Amendment is an annual adjustment to
reflect the component of the payment limit cap applicable to the fee-for service activity for the State Fiscal Year beginning July 1, 2022.
Approval Date: August 17, 2022
Effective Date: July 1, 2022

Arizona
provides state fiscal year 2022 Graduate Medical Education payment pools for new programs or expanded positions.
Approval Date: August 16, 2022
Effective Date: September 30, 2021
Topics: Financing & Reimbursement

California
extends the Private Hospital Supplemental Fund program for the state fiscal year ending 2023.
Approval Date: August 16, 2022
Effective Date: July 1, 2022

North Carolina
increases Medicaid Direct rates for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), including ICF/IID-level group homes, enrolled in the Medicaid / NC Health Choice program. ICF/IID providers receiving this rate increase shall be required to use at least eighty percent (80%) of the funding that results from the rate increase to raise pay rates to direct care employees.
Approval Date: August 16, 2022
Effective Date: February 1, 2022