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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 5121 - 5130 of 15948

Maine
Effective January 01, 2021, this amendment updates the income standards for recipients of Maine's Optional State Supplement Payments. 
Approval Date: March 19, 2021
Effective Date: January 2, 2021
Topics: Eligibility Financing & Reimbursement Program Administration

Maine
CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to Implement an add-on payment to primary care, behavioral health and dental service providers, increase reimbursement for private non-medical institutions by at least 17.2%, allow nursing facilities to relocate individuals with acquired brain injuries to a quarantine unit when diagnosed with COVID-19, allow facilities to relocate residential care patients to a nursing facility bed or nursing facility patients to a residential care bed due to COVID-19, allow pharmacies to bill for COVID-19 testing, and allow physician assistants, nurse practitioners and clinical nurse specialists to be considered qualified providers for ordering and recertifying a plan of care for private duty nursing services.
Approval Date: March 18, 2021
Effective Date: March 1, 2020
Topics: Benefits Disaster Relief Reimbursement

Ohio
Effective 12/31/2020, this amendment updates reimbursement methodology for nursing facility services - case mix scores and ventilator services.
Approval Date: March 18, 2021
Effective Date: December 31, 2020

New York
Effective 04/01/2021, this amendment establishes weekly Opioid Treatment Program (OTP) bundled fees as a payment alternative to the OTP Ambulatory Patient Group methodology.
Approval Date: March 17, 2021
Effective Date: April 1, 2021

Maine
Effective 10/01/2020, this amendment extends the timeline for uniform desk review completion from one hundred eighty days to one calendar year. 
Approval Date: March 17, 2021
Effective Date: October 1, 2020

Washington
Effective 10/01/2020, this amendment updates the information regarding telehealth/telemedicine services in the Medicaid State Plan.
Approval Date: March 17, 2021
Effective Date: October 1, 2020
Topics: Benefits Program Administration

Connecticut
Effective 10/01/2020 this amendment updates the Person-Centered Medical Home program with the physicians' services benefit category..
Approval Date: March 17, 2021
Effective Date: October 1, 2020
Topics: Benefits Financing & Reimbursement Program Administration

South Dakota
Effective 11/01/2019 this amendment clarifies that substance use disorder (SUD) early intervention services provided by a SUD agency are covered and SUD treatment services may be provided in an institution for mental disease (IMD).
Approval Date: March 17, 2021
Effective Date: November 1, 2019

Connecticut
This plan amendment updates the home health services fee schedule.
Approval Date: March 17, 2021
Effective Date: November 1, 2020

Connecticut
This amendment increases the rate for Healthcare Common Procedure Coding System code J7307- Etonogestrel implant system on the physician office and outpatient fee schedule. 
Approval Date: March 17, 2021
Effective Date: December 1, 2020