U.S. flag

An official website of the United States government

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 6141 - 6150 of 15820

Rhode Island
Proposes to reinsert covered outpatient drug reimbursement language that was inadvertently deleted in a prior amendment.
 
Approval Date: December 11, 2019
Effective Date: October 1, 2019
Topics: Financing & Reimbursement

New Jersey
Adds coverage and reimbursement for peer support services for individuals with Substance Use Disorder (SUD) or Severe Mental Illness (SMI).
Approval Date: December 11, 2019
Effective Date: July 1, 2019
Topics: Financing & Reimbursement Prescription Drugs

Florida
Proposes to adjust reimbursement for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID)
Approval Date: December 11, 2019
Effective Date: July 1, 2019
Topics: Financing & Reimbursement

South Carolina
Modifies reimbursement for ICF-IID facilities
Approval Date: December 11, 2019
Effective Date: July 1, 2019
Topics: Financing & Reimbursement

Nebraska

Removes references to “broker” or “brokering from the description for non-emergency transportation (NEMT).  NE no longer directly brokers with transportation providers for services.  For beneficiaries receiving their Medicaid through Managed Care, NEMT services have been added to the MCO contracts as of July 1, 2019.  NE will reimburse NEMT fee for service for all other Medicaid beneficiaries

Approval Date: December 11, 2019
Effective Date: July 1, 2019
Topics: Financing & Reimbursement Managed Care

Nevada
This amendment updates the reimbursement methodology for some medical/surgical procedures related to dental services.
Approval Date: December 11, 2019
Effective Date: October 1, 2019

Minnesota
Enhance the delivery of behavioral health home services for adults with serious mental illness and children/youth experiencing emotional disturbances.
Approval Date: December 10, 2019
Effective Date: October 1, 2019

New York
Authorizes supplemental payments for the 2018 outpatient services of certain public general hospitals
Approval Date: December 10, 2019
Effective Date: April 1, 2019
Topics: Cost Sharing Financing & Reimbursement

Oklahoma
Limits adult visits in Federally Qualified Health Care (FQHC) and Rural Health Care (RHC) facilities to four visits per adult member per month, and to establish that reimbursement is made for one encounter per member per day in such settings, but with specific exemptions.
Approval Date: December 10, 2019
Effective Date: September 1, 2019
Topics: Benefits Financing & Reimbursement

South Carolina
Updates the Professional Services fee schedule by utilizing the 2019 Medicare fee schedule as a basis for determining the Medicaid reimbursement.
Approval Date: December 10, 2019
Effective Date: July 1, 2019
Topics: Financing & Reimbursement