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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 221 - 230 of 15689

Nevada

This SPA authorizes an Alternative Payment Methodology (APM) for the insertion and removal of Long-Acting Reversible Contraction (LARC) Services and for LARC devices when provided at Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs).

Approval Date: January 14, 2025
Effective Date: January 1, 2025

California

This plan amendment authorizes supplemental add-on payments to the fee schedule rates for eligible ground emergency transports provided between January 1, 2024, and December 31, 2024.

Approval Date: January 13, 2025
Effective Date: January 1, 2024

Oregon

This plan amendment increased the reimbursement rates for dental services.

Approval Date: January 13, 2025
Effective Date: January 1, 2025

Arizona

This SPA updates the fee schedule rates for Multi-Specialty Interdisciplinary Clinic (MSIC) services.

Approval Date: January 13, 2025
Effective Date: January 1, 2025

Nebraska

This plan amendment proposes to clarify the calculation of medical education payments.

Approval Date: January 13, 2025
Effective Date: October 1, 2024

Maine

This plan amendment updates the payment methodology for inpatient hospital services.

Approval Date: January 13, 2025
Effective Date: July 1, 2024

Massachusetts

This amendment is to update State Plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.

Approval Date: January 13, 2025
Effective Date: December 31, 2024
Topics: Medicaid and CHIP Program (MACPro) Program Administration

New York

Updates state plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.

Approval Date: January 13, 2025
Effective Date: October 1, 2024
Topics: Program Administration

South Dakota

This Amendment adds coverage for pregnancy-related doula services.

Approval Date: January 10, 2025
Effective Date: January 1, 2025
Topics: Coverage and Reimbursement

Kentucky

This plan amendment is amending its state plan to transition from the RUG III methodology to the Patient Driven Payment Model (PDPM) to calculate each individual price-based long term care facility’s average case-mix.

Approval Date: January 8, 2025
Effective Date: July 1, 2024