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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 3741 - 3750 of 15826

Washington
Updates references to the 3M APR-DRG software grouper used to group hospital claims for payment.
Approval Date: May 3, 2022
Effective Date: May 1, 2022

California
This SPA amends the Alternative Benefit Plan (ABP) to restore comprehensive adult optional dental benefits, subject to medical necessity and utilization controls, for eligible adults. This SPA aligns the ABP with the restoration of adult optional dental benefits in the State Plan under the approval of SPA 17-0027.
Approval Date: May 3, 2022
Effective Date: January 1, 2018
Topics: Alternative Benefit Plan

Texas
This SPA amends to implement changes to state law meant to further the use of telemedicine and telehealth by allowing the option to receive certain services using an audio-only platform.
Approval Date: May 3, 2022
Effective Date: February 1, 2022

Oklahoma
This amendment updates the frequency of Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) dental oral prophylaxis services from eve1y 184 days to eve1y six months.
Approval Date: May 3, 2022
Effective Date: September 1, 2022

Arkansas
This amendment proposes allows pharmacists to enroll individually as atypical providers to prescribe and administer specified drugs, and test and screen for certain health conditions.
Approval Date: May 3, 2022
Effective Date: June 1, 2022

Connecticut
Effective January 1, 2022 this amendment proposes  to add mandatory coverage of routine patient costs furnished in connection with participation in qualifying clinical trials.
Approval Date: May 3, 2022
Effective Date: January 1, 2022

Illinois
This amendment implement Sections 1905(a)(30) and 1905(gg) of the Social Security Act, which require coverage of routine patient costs associated with participation in qualifying clinical trials.
Approval Date: May 2, 2022
Effective Date: January 1, 2022

Arkansas
This amendment establishes soft annual limits of $500 on radiology and diagnostic laboratory services, respectively.
Approval Date: May 2, 2022
Effective Date: July 1, 2022

District of Columbia
 To effectuate the coverage of routine patient costs incurred during qualified clinical trials from January 1, 2022 forward, as required by the Consolidated Appropriations Act, 2021, Division CC, Title II, Section 210.
Approval Date: May 2, 2022
Effective Date: January 1, 2022

Nevada
This SPA amendment is to allow coverage of routine patient costs furnished in connection with participation in a qualifying clinical trial.
Approval Date: May 2, 2022
Effective Date: January 1, 2022