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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 3481 - 3490 of 15690

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

Connecticut
This plan makes several updates under the physician and audiology services.
Approval Date: June 13, 2022
Effective Date: January 1, 2022

Idaho
This amendment proposes to cover routine patient costs for Medicaid beneficiaries participating in qualifying clinical trials.
Approval Date: June 13, 2022
Effective Date: January 7, 2022
Topics: Coverage and Reimbursement

New Mexico
Description: This SPA adds coverage of routine patient costs associated with participation in qualifying clinical trials to Alternative Benefit Plan (ABP).
Approval Date: June 13, 2022
Effective Date: January 1, 2022

Alabama
allows enhanced payments to physicians associated with teaching hospitals.
Approval Date: June 13, 2022
Effective Date: January 1, 2020
Topics: Financing & Reimbursement Program Administration

Idaho
This SPA expand passive enrollment of the Medicare-Medicaid Coordinated Alternative Benefit Plan to three additional counties where there is only one participating health plan.
Approval Date: June 13, 2022
Effective Date: April 1, 2022
Topics: Average Sales Price (ASP)

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  allow the state Medicaid agency to reimburse FQHCs at the fee schedule amount for administration of Covid-19 vaccines.
Approval Date: June 10, 2022
Effective Date: January 1, 2021
Topics: Disaster Relief 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 add a Nursing Facility payment 4/1/22-6/30/22 and correct ASC procedure code 36561 payment amount from $1,813.06 to $1,831.06, effective 8/26/2021.
Approval Date: June 10, 2022
Effective Date: August 26, 2021
Topics: Disaster Relief Reimbursement