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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 5721 - 5730 of 15783

California
Adds Orange County (Group 4) to the existing Health Home Program with the population criterion of Serious Mental Illness (SMI) or Serious Emotional Disturbance (SED)
Approval Date: April 22, 2020
Effective Date: July 1, 2020

Louisiana

This SPA amends the provisions governing school-based medical services covered in the Early and Periodic Screening, Diagnosis and Treatment Program and school-based behavioral health services in order to: (1) add services categorized as 504 plans, individual health plans or otherwise medically necessary in addition to those covered by an individual education plan, to the services available for school-based Medicaid claiming; (2) amend the reimbursement methodology to expand allowable billing providers for direct/therapy and nursing services; and (3) add applied behavioral analysis, personal care services and transportation to allowable Medical billing.

Approval Date: April 21, 2020
Effective Date: March 20, 2019
Topics: Program Administration

New Hampshire
Updates the allowance for a 3.1% increase to prosthetic devices, durable medical equipment and supplies, and
eyeglass rates
Approval Date: April 21, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

New Hampshire

updates the allowance for a 3.1% increase in extended services to pregnant women and personal care reimbursement rates

Approval Date: April 21, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Maine
streamlines the eligibility process by implementing MAGI-like methodologies for pregnant women, children and parent-caretaker relatives under MNIL
Approval Date: April 21, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

New Hampshire

updates the allowance for a 3.1% increase to the hospice and freestanding birth rates.

Approval Date: April 21, 2020
Effective Date: January 1, 2020
Topics: Financing & Reimbursement

Colorado
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing, and waive cost-sharing for testing services, testing-related services, and treatments for COVID-19.
Approval Date: April 21, 2020
Effective Date: March 1, 2020
Topics: Cost Sharing Disaster Relief Eligibility

Puerto Rico
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing, impose less restrictive resource tests on certain eligibility groups, and to continue to consider residents who leave the Territory due to the disaster residents of the Territory.
Approval Date: April 21, 2020
Effective Date: March 1, 2020
Topics: Disaster Relief Eligibility

South Carolina
Proposes to update the current Medicaid nursing facility rates for all private and non-state owned governmental facilities by providing for a COVID-19 4% add-on to assist and reimburse nursing facilities for the unanticipated costs incurred in their response to its coronavirus protection of residents as well as facility staff
Approval Date: April 21, 2020
Effective Date: March 1, 2020
Topics: Disaster Relief Financing & Reimbursement

Louisiana
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing, suspend all cost sharing, extend all prior authorization by automatic renewal without clinical review or time/quantity extensions, expand telehealth, adjust prior authorizations for medications, and increase certain payment rates.
Approval Date: April 20, 2020
Effective Date: March 1, 2020
Topics: Benefits Cost Sharing Disaster Relief Eligibility Financing & Reimbursement Prescription Drugs