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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 2521 - 2530 of 15693

Illinois
This amendment provides a rate increase for Maternal Services.
Approval Date: April 3, 2023
Effective Date: January 1, 2023

Michigan
Chronic Care Management for Individuals with Serious and Persistent Mental Health Conditions to expand the Behavioral Health Home to more geographic areas and update staffing requirements to allow flexibility for the required provider infrastructure.
Approval Date: April 3, 2023
Effective Date: May 1, 2023

Arizona
This amendment, effective October 1, 2022, updates the Arizona nursing facility supplemental payment pool description.
Approval Date: March 29, 2023
Effective Date: October 1, 2022

Georgia
This State Plan Amendment adjusts base per diem rates for Psychiatric Residential Treatment Facility (PRTF) services rendered to persons under age 21 as follows: PRTFs will be reimbursed at provider-specific prospective rates based on the SFY 2020 or more recently available cost reports, including a 5% inflation factor and removing a cost cap provision. The per diem rate for children with a co-occurring diagnosis of autism will be at prospective rates based on 2020 or more recently available cost reports specific to service delivery of children with co-occurring diagnoses. The amendment also removes a utilization standard of 90% operation capacity.
Approval Date: March 29, 2023
Effective Date: January 14, 2022

District of Columbia
To adopt certain income disregards and make various eligibility-related updates to the state plan.
Approval Date: March 29, 2023
Effective Date: October 1, 2022

Maine
To clarify plan language in connection with recent federal guidance. This SPA has been submitted as related to Inflation Reduction Act of 2022 temporary, 5-year increase for for physician administered biosimilars drugs that will be paid Medicare's Average Sales Price (ASP) plus 8% (rather than plus 6%).
Approval Date: March 28, 2023
Effective Date: October 1, 2022

New York
This plan continues the additional 25 percent rate enhancement initially authorized as a temporary increase under provisions of section 9817 of the American Rescue Act of 2021 (ARPA) for Children and Family Treatment and Support Services (CFTSS).
Approval Date: March 27, 2023
Effective Date: October 1, 2022

Kansas
This amendment is a biennial update of the Medicaid Indirect Medical Education Factor.
Approval Date: March 27, 2023
Effective Date: January 1, 2023

North Carolina
This amendment modifies nursing facility service rates by adding a direct care facility stabilization add-on to the calculation of the per diem direct rate for existing and new facilities.
Approval Date: March 27, 2023
Effective Date: November 1, 2022

Maine
This plan amendment updates the reimbursement methodology for physician services to align payment for topical fluoride varnish with the applicable dental service reimbursement methodology.
Approval Date: March 27, 2023
Effective Date: August 1, 2022