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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 2391 - 2400 of 15693

Montana
This plan amendment updates the distribution for add-on payments for Direct Care Wages and Health Insurance for Health Care
Workers and also updates the Personal Care Services (PCS) reimbursement section and reference to the fee schedule.
Approval Date: May 8, 2023
Effective Date: July 1, 2021

Ohio
Makes administrative corrections to Ohio's Alternative Benefit Plan (ABP), specifically ABP 5, to better align it with the Medicaid State Plan.
Approval Date: May 8, 2023
Effective Date: January 1, 2023
Topics: Alternative Benefit Plan

Arizona
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 lump sum payments to select providers.
Approval Date: May 5, 2023
Effective Date: January 1, 2023
Topics: Disaster Relief Reimbursement

District of Columbia
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 housing supportive services provider qualification criteria, provide reimbursement for retroactive provider rate changes, to increase the personal needs allowance, and to waiver pharmacy signature requirements.
Approval Date: May 5, 2023
Effective Date: March 1, 2020
Topics: Disaster Relief Eligibility Home and community based services Prescription Drugs Reimbursement

Massachusetts
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency.  The purpose of this amendment is an amendment to disregard monies received by any member or applicant as part of a settlement agreement with residents of the Holyoke Soldier's Home for the purpose of determining eligibility.
Approval Date: May 5, 2023
Effective Date: May 1, 2022
Topics: Disaster Relief Eligibility

New Hampshire
Effective January 1, 2023, this amendment establishes swing bed reimbursement rate methodology in the state plan.
Approval Date: May 5, 2023
Effective Date: January 1, 2023

Illinois

This SPA proposes new inpatient and outpatient hospital payment methodologies.

Approval Date: May 5, 2023
Effective Date: January 1, 2023

New Jersey

This SPA proposes to amend the pharmacy page's provision to cover all prescriptions for FDA-approved oral contraceptives for up to a 12-month supply at one time.

Approval Date: May 5, 2023
Effective Date: January 1, 2023
Topics: Coverage Covered Outpatient Drug Prescribed Drugs Prescription Drugs

Florida
This state plan amendment eliminates certain hospital rate enhancements (AREs) from the state plan and updates Diagnosis Related Group (DRG) reimbursement rates for hospital inpatient services in order to adjust rates for providers that previously received AREs and participated or did not participate in year one of the state's Directed Payment Program (DPP). The amendment also increases payments for the purpose of raising wages for employees of Medicaid providers to at least $15.00 per hour, includes a Children’s Hospital per-discharge add-on payment, modifies the payment methodology for GME to update the list of specialties in statewide supply-and-demand deficit, adds funding for mental health and psychiatry resident positions, provides an increase in the organ transplant provider rate, and makes technical and editorial changes.
Approval Date: May 4, 2023
Effective Date: July 1, 2022

Florida
This state plan amendment updates Long-Term Care Reimbursement provisions related to provider submission requirements when submitting annual Fair Rental Value (FRV) surveys, specifies that the state may amend FRV survey data based on audit results, removes a transitional rate provision in place since 2016 that reimbursed at the greater of a provider's prospective payment rate or its previous cost-based rate, increases funding to providers to establish a legislatively mandated $15.00 minimum wage, and updates State Plan UPL methodology to specify the use of the most recent cost reports for 2022-2023 UPL calculation.
Approval Date: May 4, 2023
Effective Date: July 1, 2022