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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 2541 - 2550 of 15693

New Jersey
CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency.  The purpose of this amendment is to temporarily extend for one year the following disaster relief flexibilities: targeted case management, telehealth, drug benefit, and behavioral health home requirements.
Approval Date: March 24, 2023
Effective Date: May 12, 2023
Topics: Benefits Disaster Relief Prescription Drugs Reimbursement

Oregon
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to allow Tribal 638 Health Programs enrolled with the Oregon Health Plan (OHP) as an FQHC to use the Indian Health Service Memorandum of Understanding All-inclusive Rate (IHS MOU AIR Rate) for Medicaid reimbursement, rather than a clinic-specific Prospective Payment System (PPS) Rate as an Alternative Payment Methodology (APM).
Approval Date: March 24, 2023
Effective Date: January 1, 2023
Topics: Disaster Relief Reimbursement

Vermont
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 premiums and cost-sharing. It reverts to co-pay amounts prior to the public health emergency (PHE) with exception of services, drugs, test and vaccines for treatment of COVID-19.
Approval Date: March 24, 2023
Effective Date: February 1, 2023
Topics: Disaster Relief Eligibility

California
This amendment is to update the definition of a visit to include telehealth services in Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and Tribal Health programs and adds associate marriage and family therapists (AMFTs) and associate clinical social workers (ACSWs) in FQHCs and RHCs.
Approval Date: March 24, 2023
Effective Date: March 14, 2023
Topics: Coverage and Reimbursement

Oklahoma
This SPA provides Oklahoma with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Approval Date: March 23, 2023
Effective Date: January 1, 2023

Hawaii
Pregnant Woman Proxy Payment Methodology-state plan amendment is needed to describe the payment methodology for Hawaii selection in SPA 22-0008 to extend medicaid coverage post-pregnancy from 60 days to 12 months.
Approval Date: March 23, 2023
Effective Date: April 1, 2022
Topics: Federal Financial Participation

New Mexico
This amendment approved that the state will pay for prenatal genetic screening and prenatal fetal screening to determine if the fetus has the potential to born with a genetic condition or birth defect.
Approval Date: March 23, 2023
Effective Date: February 1, 2023

Colorado
Effective for services on or after October 1, 2022, this amendment adds clarifying language specific to Disproportionate Share Hospital (DSH) payments as well as updates the hospital quality incentive payments available for qualifying providers.
Approval Date: March 23, 2023
Effective Date: October 1, 2022

Ohio
Proposes a resource disregard for individuals who received refunds of premiums paid while enrolled in Ohio's Ticket to Work Basic and Medically Improved eligibility groups.
Approval Date: March 22, 2023
Effective Date: December 1, 2022

Kansas
This amendment increases the Nursing Facility 24-hour Ventilator Dependent Program Per Diem rate.
Approval Date: March 22, 2023
Effective Date: January 1, 2023