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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 12961 - 12970 of 15759

Rhode Island
This SPA approves the transition of the single -state agency designation from the Department or Human services (DHS) to the Executive Office of Health and Human Services (EOHHS).
Approval Date: August 2, 2012
Effective Date: July 1, 2011
Topics: Program Administration

Connecticut
This SPA proposed to amend the maximum allowable cost for selected multi-source brand and generic drugs to range from average wholesale price (A WP) minus 72 percent to step down tiers through A WP minus 20 percent based on meeting specific invoice pricing criteria.
Approval Date: August 2, 2012
Effective Date: November 1, 2011

North Carolina
This amendment proposes to clarify the description of prescribed drugs, revise the reimbursement methodology for North Carolina Estimated Acquisition Cost (NCEAC) for prescribed drugs and establish a 4 rate tier generic dispensing fee structure for reimbursement.
Approval Date: August 2, 2012
Effective Date: February 1, 2012

North Carolina
This amendment proposes to revise the reimbursement methodologies for physician drugs to Average Sales Price (ASP) plus 6% or where there is no ASP, to Average Wholesale Price (AWP) less 10 percent and for the contraceptive drugs Implanon and Mirena, to Wholesale Acquisition Cost (WAC) plus 6 percent. The state also proposes to freeze reimbursement rates for the Physician Drug Program effective for state fiscal years 2010 - 2012 as indicated in the SPA.
Approval Date: August 2, 2012
Effective Date: December 1, 2011
Topics: Financing & Reimbursement

Arkansas
Udates Policies for Self-Directed Personal Assistance Services.
Approval Date: August 2, 2012
Effective Date: January 13, 2012

Iowa
This change implements a change to the pharmacy dispensing fee from $4.34 to $6.20 for date.
Approval Date: August 2, 2012
Effective Date: August 1, 2011

Massachusetts
Incorporates Express Lane Eligibility Option for Children Receiving Medicaid.
Approval Date: August 2, 2012
Effective Date: January 23, 2012

Utah
Pharmacy rates; changing payment rate from AWP to Utah Wholesale Price.
Approval Date: August 2, 2012
Effective Date: November 1, 2012

Michigan
This amendment revises the long term care provider appeals process.
Approval Date: August 1, 2012
Effective Date: April 1, 2012
Topics: Program Administration

New York
Continued reduction to Inpatient statewide base price (FMAP=50%).
Approval Date: August 1, 2012
Effective Date: May 1, 2012
Topics: Financing & Reimbursement