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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 10501 - 10510 of 15975

Montana
This SPA arnends the Outpatient Hospital Services reimbursement to include an approximate 9. 7% rate increase; update the reference to the CMS form used to identify outpatient costs for cost reporting purposes; clarify that dental services not grouping to an ambulatory payment classification ( APC) will be reimbursed as specified in the department' s outpatient fee schedule; and remove the language that reimburses CPT codes 99281 and 99282 for emergency room visits based upon the lowest level clinic visit APC weight.
Approval Date: February 9, 2015
Effective Date: July 1, 2014

Kansas
Positive Behavioral Support Services.
Approval Date: February 9, 2015
Effective Date: January 1, 2014

Connecticut
Revises the reimbursement methodology for privately owned and opened intermediate care facilities for intellectually disabled.
Approval Date: February 6, 2015
Effective Date: May 1, 2014

Georgia
Establishes that One or More Qualified Hospitals are Determining Presumptive Eligibility, and that the State is Providing Coverage for Individuals Determined Presumptively Eligible.
Approval Date: February 6, 2015
Effective Date: January 1, 2014

Nevada
Updates nursing facility per diem rates for high cost Pediatric levels of care 1 and 2 for individuals less than age 21.
Approval Date: February 6, 2015
Effective Date: November 14, 2014

Alaska
Uses the National Drug Acquisition Cost (NADAC) prices, as provided by the Centers for Medicare and Medicaid Services (CMS), as the state maximum allowable cost (SMAC) for both brand and generic drugs.
Approval Date: February 5, 2015
Effective Date: July 1, 2014
Topics: Financing & Reimbursement Prescription Drugs Program Administration

New York
FMAP Free Standing Birth Centers.
Approval Date: February 4, 2015
Effective Date: October 1, 2013
Topics: Financing & Reimbursement Program Administration

Maine
Adds Ambulatory Surgical Centers under the clinic services section of the state plan.
Approval Date: February 3, 2015
Effective Date: July 1, 2014

Pennsylvania
This amendment proproses to add compounded prescriptions, Mozobil, Ranexa, Rilutek, Soliris, and Xenazine to the list of drugs that require prior authorization.
Approval Date: February 3, 2015
Effective Date: December 9, 2014

New York
Modified Adjusted Gross Income Eligibility.
Approval Date: February 3, 2015
Effective Date: January 1, 2014