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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 3561 - 3570 of 15689

New Hampshire
New Hampshire clarifies that the state appropriately covers and pays for routine patient costs of items and services for beneficiaries enrolled in qualifying clinical trials, as newly required under amendments made by Section 210 of the CAA. NH provides coverage for these costs already—no new items or services are being covered, and no payment methodologies are being changed.
Approval Date: May 20, 2022
Effective Date: January 1, 2022

Iowa
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is to modify the definition of home-based habilitation to include health and safety supports and services required to maintain a member’s involvement in online education or e-learning, specifically for members ages 17-21 residing outside of the family home. In addition, the SPA seeks approval for retainer payments made in April 2020 to providers of 1915(i) state plan home and community based (HCBS) habilitation services including day habilitation, prevocational services, and supported employment.
Approval Date: May 19, 2022
Effective Date: August 31, 2021
Topics: Benefits Disaster Relief Home and community based services Reimbursement

Pennsylvania
Reauthorize and continue a series of additional classes of DSH payments for qualifying acute care general hospitals.
Approval Date: May 19, 2022
Effective Date: February 13, 2022
Topics: Financing & Reimbursement

Pennsylvania
Authorizes supplemental payments to qualifying nursing facilities located in a county of the first class.
Approval Date: May 19, 2022
Effective Date: January 9, 2022
Topics: Financing & Reimbursement

Pennsylvania
Authorizes supplemental payments to qualifying nursing facilities providing ventilator and
tracheostomy care.
Approval Date: May 19, 2022
Effective Date: January 9, 2022
Topics: Financing & Reimbursement

Idaho
This amendment to update the Idaho State Plan regarding third party liability.
Approval Date: May 19, 2022
Effective Date: January 1, 2022

Oregon
This Alternative Benefit Plan amendment is to comply to the Consolidated Appropriations Act for 2021, which amended the Medicaid statute to add as a mandatory benefit, in both state plan and benchmark and benchmark equivalent coverage, for “routine patient costs for items and services furnished in connection with a qualifying clinical trial.”
Approval Date: May 19, 2022
Effective Date: January 1, 2022
Topics: Alternative Benefit Plan

Nevada
Calculation of state supplemental pharmacy rebate amounts in accordance with the National Medical Pooling Initiative (NMPI). This change will allow Nevada to receive additional supplemental rebate amounts and generate savings for the state.
Approval Date: May 19, 2022
Effective Date: July 1, 2022
Topics: Coverage and Reimbursement

Vermont
SPA proposes to align substance use disorder (SUD) state plan services with the currently approved alternative benefit plan (ABP).
Approval Date: May 18, 2022
Effective Date: January 1, 2019

Iowa
This amendment establishes compliance with mandatory Medicaid coverage and reimbursement of routine patient costs furnished in connection with participation in qualifying clinical trials.
Approval Date: May 18, 2022
Effective Date: January 1, 2022