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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 3471 - 3480 of 15690

North Dakota
Amends the State Plan to include the Medicare Fee Schedule in the overall lesser of logic calculation for physician administered drugs.
Approval Date: June 15, 2022
Effective Date: April 1, 2022
Topics: Prescribed Drugs Reimbursement

Montana
On March 31, 2022, the Centers for Medicare and Medicaid Services (CMS) received Montana State Plan Amendment (SPA) MT-22-0002, in which the state proposed to increase the general income disregard for medically needy individuals from $100 to $269 per month, and to further modify the disregard consistent with Social Security Administration cost-of-living adjustments beginning in 2023 and in subsequent years.
Approval Date: June 15, 2022
Effective Date: January 1, 2022

Maryland
To implement a Home Visiting Services program to offer informational support, and facilitate screening and care coordination to support healthy outcomes through pregnancy and up to a child’s second or third birthday, depending on the program of enrollment. Services will be provided by specially trained professionals within the Healthy Families America (HFA) and Nurse Family Partnership (NFP) services programs.
Approval Date: June 15, 2022
Effective Date: January 1, 2022

Maryland
To implement coverage for doula services including continuous physical, emotional, and informational support to the birthing parent during the prenatal, labor & delivery, and postpartum periods.
Approval Date: June 15, 2022
Effective Date: January 1, 2022

Connecticut
1)Incorporates federal HCPCS updates to Medical Clinic and Ambulatory Surgical Center fee schedules to remain compliant with
HIPAA; 2. Adds payment for specified drugs on Family Planning Clinic fee schedule; 3. As federally required by approved state
plan, updates physician-administered drug rates on Dialysis Clinic, Behavioral Health Clinic, and Medical Clinic fee schedules.
Approval Date: June 14, 2022
Effective Date: January 1, 2022
Topics: Financing & Reimbursement Physician Administered Drugs Program Administration

Massachusetts
revises nursing facility 2022 rate year reimbursement methods to establish new rate add-ons, amend existing rate add-ons, and further update certain COVID-19 related payments. The proposed amendment also includes reimbursement methodology to distribute state legislative appropriation in the amount of $25 million for workforce retention and recruitment initiatives.
Approval Date: June 14, 2022
Effective Date: January 15, 2022

Wisconsin
modifies inpatient and outpatient reimbursement rates, including for critical care supplements, wage area adjustment indices for border status hospitals, cost-to-charge ratios, and outpatient access payments.
Approval Date: June 14, 2022
Effective Date: January 1, 2022

New Hampshire
revises the quarterly nursing home supplemental payment, also known as MQIP, for dates of service in the quarter ending March 31, 2022.
Approval Date: June 14, 2022
Effective Date: January 1, 2022
Topics: Financing & Reimbursement

South Carolina
This SPA was submitted to provide routine coverage of routine patient cost associated with participation in qualifying clinical trials and to comply with Div. CC, Title II, Section 210 of the Consolidated Appropriations Act, 2021 (P.L.116-260).
Approval Date: June 14, 2022
Effective Date: January 1, 2022
Topics: Benefits Disaster Relief Reimbursement

Georgia
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to update nursing home rate components for general liability, property insurance, and property tax pass-through to the 2021 cost report.
Approval Date: June 14, 2022
Effective Date: July 1, 2021
Topics: Disaster Relief Reimbursement