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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 2311 - 2320 of 15696

Colorado
This amendment add the populations served by the following 1915(c) HCBS waivers as target groups for Targeted
Case Management: Brain Injury (BI), Children's Home and Community Based Services (CHCBS),Children with Life Limiting Illness (CLLI) Complementary and Integrative Health (CIH), Community Mental Health Supports (CMHS), and Elderly, Blind, and Disabled (EBD).
Approval Date: May 24, 2023
Effective Date: July 1, 2023
Topics: Coverage and Reimbursement

Nevada
This SPA proposes to update the reimbursement methodology for physician administered drugs (PAD) to include the Nevada Medicaid’s PAD fee schedule.
Approval Date: May 23, 2023
Effective Date: July 1, 2023
Topics: Physician Administered Drugs Reimbursement

South Dakota
This SPA was submitted to add an Alternative Benefit Plan (ABP) to South Dakota’s state plan to cover the Medicaid Expansion
Population, effective July 1, 2023.
Approval Date: May 23, 2023
Effective Date: July 1, 2023
Topics: Alternative Benefit Plan

South Dakota
The state adopts the the eligibility group serving individuals under age 65 with incomes at or below 133% of the federal poverty level (FPL), as described in section 1902(a)(10)(A)(VIII) of the Social Security Act.
Approval Date: May 23, 2023
Effective Date: July 1, 2023
Topics: Eligibility Medicaid and CHIP Program (MACPro)

South Dakota

This SPA adds the newly expanded adult eligibility group as an included population and implements per member per month payments for eligible Indian Health Services (IHS), Tribal 638, Urban Indian Health, and Federally Qualified Health Centers/Rural Health Clinic (FQHC/RHC) facilities.

Approval Date: May 23, 2023
Effective Date: July 1, 2023

South Dakota
This SPA describes the methodology used by the state for determining the appropriate FMAP rates, including the increased FMAP rates, available under the provisions of the Affordable Care Act applicable for the medical assistance expenditures under the Medicaid program associated with enrollees in the new adult group adopted by the state and described in 42 CFR 435.119.
Approval Date: May 23, 2023
Effective Date: July 1, 2023
Topics: Eligibility Federal Financial Participation

Utah

This SPA proposes to update the excluded drug coverage language, as well clarify that for claims billed through the pharmacy point of sale system will be reimbursed using the reimbursement methodology found in Attachment 4.19-B for prescribed drugs.

Approval Date: May 23, 2023
Effective Date: October 1, 2022
Topics: Covered Outpatient Drug Home Health Prescribed Drugs

Washington
This amendment is to adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act.
Approval Date: May 23, 2023
Effective Date: January 1, 2023
Topics: Eligibility Medicaid and CHIP Program (MACPro)

New Jersey

This SPA proposes to amend the language provisions for coverage of selective non-legend outpatient drugs. This SPA also updates additional Pharmacy coverage items on the State Plan pages.

Approval Date: May 23, 2023
Effective Date: January 1, 2023
Topics: Coverage Prescribed Drugs

North Dakota
State is increasing the rates for the following 1915(i) services: peer support, family peer support, and training and supports for unpaid caregivers. Other revisions to the state plan include modifications to the requirements of care coordinators, individual provider qualifications for the housing support service, and the quality remediation process for quality measures in the state plan.
Approval Date: May 22, 2023
Effective Date: May 22, 2023
Topics: Home and community based services