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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 3391 - 3400 of 15693

Colorado
upgrades the version of Enhanced Ambulatory Patient Group (EAPGs) in use for calculation of fee for service outpatient hospital payment in order to align payment with modern outpatient healthcare delivery standards.
Approval Date: July 6, 2022
Effective Date: January 1, 2022

California
Updates the payment methodologies for the Outpatient Disproportionate Share Hospital (OP DSH) and Outpatient Small and Rural Hospital (OP SRH) supplemental reimbursement programs.
Approval Date: July 5, 2022
Effective Date: July 1, 2022

Missouri
Provides additional reimbursement to nursing facilities for increases in costs associated with staffing, supplies, social distancing standards, and other factors due to the COVID-19 national emergency.
Approval Date: July 5, 2022
Effective Date: July 1, 2022

Oklahoma

Established the Ambulance Service Provider Access Payment Program.

Approval Date: July 5, 2022
Effective Date: January 1, 2022

New Hampshire
Added a new 1915(i)HCBS Benefit.
Approval Date: July 1, 2022
Effective Date: July 1, 2022

Illinois
This amendment is to allow licensed clinical professional counselors and licensed marriage and family therapists to enroll in Medicaid and bill fee-for-service.
Approval Date: July 1, 2022
Effective Date: December 1, 2021
Topics: Coverage and Reimbursement

Washington
This SPA provides Washington with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Approval Date: June 30, 2022
Effective Date: April 1, 2022

California
This amendment is to clarify the Department of Health Care Services’ third-party liability practices for prenatal services and child support enforcement services.  It also amends exceptions for recovery practices and updates Medicare thresholds.
Approval Date: June 30, 2022
Effective Date: July 1, 2022

New Hampshire
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 for a mechanism to make provider payments to be used for workforce investment for direct care HCBS workers and is a component of New Hampshire's HCBS Spending Plan.
Approval Date: June 29, 2022
Effective Date: April 1, 2021
Topics: Disaster Relief Home and community based services Reimbursement

Arizona
This SPA attests to the state’s coverage of COVID-19 vaccines and administration of vaccines, as required by section 1905(a)(4)(E) of the the Social Security Act. CMS supports this change, as it is required by statute.
Approval Date: June 29, 2022
Effective Date: March 11, 2021
Topics: Benefits Disaster Relief Reimbursement