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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 2811 - 2820 of 15693

Maryland
For dates of service beginning August 1, 2022, the Department is establishing reimbursement methods for vaccine administration for federally purchased vaccines to adults (e.g. COVID-19). MDH is providing payment for administration of monkeypox and/or smallpox vaccinations at a rate of $23.28 per dose.
Approval Date: December 20, 2022
Effective Date: August 1, 2022

Massachusetts
This plan amendment updates implements supplemental payments for nonpublic ambulance providers.
Approval Date: December 20, 2022
Effective Date: July 7, 2022

Connecticut
This amendment implements an acuity-based reimbursement methodology for nursing facilities phased in over a
three-year period.
Approval Date: December 20, 2022
Effective Date: July 1, 2022

Arkansas

This SPA proposes to update language and the reimbursement methodology for 340B Antihemophilic
Factor products and Physician Administered Drugs.

Approval Date: December 20, 2022
Effective Date: April 1, 2023
Topics: Covered Outpatient Drug Physician Administered Drugs Prescription Drugs Reimbursement

Maine
Effective July 1, 2022, this amendment implements an add-on component to enable nursing facilities to cover labor costs for essential support workers to equal at least 125% of the state minimum wage, plus related taxes and benefits. The amendment also eliminates the requirement for base-year direct and routine aggregate costs per day to be less than the median aggregate direct and routine allowable costs for a facility’s peer group, so that all facilities with MaineCare days constituting more than 80% of total days across all payers will receive a High MaineCare Utilization Payment of $0.60 per diem for each one percentage (1%) of MaineCare days above 80%.
Approval Date: December 20, 2022
Effective Date: July 1, 2022

Vermont
This SPA provides a Disproportionate Share Hospital(DSH) One-Time Additional Payment.
Approval Date: December 20, 2022
Effective Date: September 16, 2022

Idaho
Renewing Idaho’s Home and Community Base Services (HCBS)1915, Yes Empowerment Services (YES) State Plan Benefit, targeting children with serious emotional disturbances (SED). This benefit will provide respite services for children and youth who have a substantial functional impairment that is measured by and documented through the use of a standardized instrument conducted or supervised by a qualified independent assessor clinician.
Approval Date: December 20, 2022
Effective Date: January 1, 2023
Topics: Home and community based services

Virgin Islands
To remove the cash required to pay Part B premiums. VI will pay Part B premiums for all beneficiaries who also qualify for Medicare.
Approval Date: December 19, 2022
Effective Date: July 1, 2022

Alaska
This amendment updates Alaska’s Alternative Benefit Plan (ABP) to align with Alaska’s Medicaid State Plan with revisions to the preventive services, vision services, and therapy services which includes physical therapy, occupational therapy, and speech-language therapy in accordance with the ten essential health benefits requirements for ABPs.
Approval Date: December 19, 2022
Effective Date: October 1, 2022
Topics: Alternative Benefit Plan

Rhode Island
This amendment proposes to establish a Mental Health Psychiatric Rehabilitation Residences (MHPRR) tier for High Intensity clients.
Approval Date: December 19, 2022
Effective Date: July 19, 2022
Topics: Coverage and Reimbursement