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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 2431 - 2440 of 15998

Massachusetts
Effective January 1, 2023 this amendment revises rate year (RY) 2023 reimbursement for privately-owned acute care hospital services. Specifically, it implements payment for: behavioral health crisis evaluation services; acute inpatient discharge add-on; and a Clinical Quality Incentive (CQI) program.
Approval Date: June 26, 2023
Effective Date: January 1, 2023

Arkansas

This amendment proposes to update the Alternative Benefit Plan population, voluntary benefit package selection process and the process for exempting members from mandatory enrollment.

Approval Date: June 26, 2023
Effective Date: April 1, 2023

Kentucky
To implement 12-month continuous eligibility for children.
Approval Date: June 26, 2023
Effective Date: April 1, 2023

Maryland
To include coverage for peer recovery support services within the state’s Other Diagnostic, Screening, Preventive and Rehabilitative Services benefit and the Mandatory Medication-Assisted Treatment (MAT) benefit. Individual peer support services will be reimbursed at a rate of $16.38 per 15-minute unit, and group peer support services will be reimbursed at a rate of $4.55 per 15-minute unit. This SPA also removes the DATA 2000 waiver requirement for the prescribing of buprenorphone for opioid use disorder.
Approval Date: June 26, 2023
Effective Date: June 1, 2023

Oklahoma
This amendment proposes to add doula service coverage, providing emotional, physical, and informational support services during the prenatal, labor and delivery, and postpartum periods.
Approval Date: June 26, 2023
Effective Date: July 1, 2023

Colorado
To revise Colorado"s paper alternative single. streamlined application and the paper alternative application used for multiple human services programs.
Approval Date: June 26, 2023
Effective Date: July 1, 2022
Topics: Eligibility Medicaid and CHIP Program (MACPro)

Texas

This SPA proposes to update the state's excluded drug list to include selective non-prescription drugs and other excluded drugs and list them on the state's website.

Approval Date: June 23, 2023
Effective Date: January 1, 2023

Vermont

This amendment proposes to update the coverage description and prior authorization policies for transplantation services.

Approval Date: June 23, 2023
Effective Date: May 1, 2023
Topics: Coverage Prior Authorization Program Administration

Vermont
This amendment proposes to update the coverage description and prior authorization policies for transplantation services.
Approval Date: June 23, 2023
Effective Date: May 1, 2023

US Virgin Islands
This SPA provides the United States Virgin Islands with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Approval Date: June 23, 2023
Effective Date: October 1, 2022