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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 12761 - 12770 of 15783

New Jersey
This amendment proposed to change the drug ingredient cost reimbursement from Average Wholesale Price (AWP) minus 17. 5% to Wholesale Acquisition Cost (WAC) minus 1%. This amendment is a straight line reimbursement adjustment as it equalizes the WAC metric to the current AWP metric.
Approval Date: November 21, 2012
Effective Date: July 1, 2012

Arkansas
The plan amendment allows individuals under the age of 21 to receive treatment for terminal illness in addition to hospice services. The plan amendment does not have a direct impact on Indians, Indian Health programs, or Urban Indian Organizations.
Approval Date: November 21, 2012
Effective Date: January 1, 2013

Colorado
Updates RX Review Programs pharmacist qualifications and referral requirements.
Approval Date: November 21, 2012
Effective Date: March 1, 2012

South Carolina
Update to the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Periodicity Schedule.
Approval Date: November 21, 2012
Effective Date: July 1, 2012

New Mexico
Updates the service description and limits of personal care services.
Approval Date: November 21, 2012
Effective Date: June 1, 2012
Topics: Program Administration

Rhode Island
State Medical Care Advisory Committee - Tribal Consultation Requirements.
Approval Date: November 21, 2012
Effective Date: July 1, 2012
Topics: Program Administration

California
Provider Screening and Enrollment.
Approval Date: November 21, 2012
Effective Date: January 1, 2013

Delaware
Estate Recovery and Managed Care - Total Capitation Payment.
Approval Date: November 21, 2012
Effective Date: April 1, 2012
Topics: Financing & Reimbursement

Washington
This amendment updates the school based services fee schedule by an average of 3.55 percent.
Approval Date: November 21, 2012
Effective Date: January 1, 2012

Connecticut
This proposed SPA transmitted an amendment to Connecticut's approved Title XIX State plan to exclude the amount of the Connecticut Earned Income Tax Credit in determining Medicaid eligibility for the eligibility groups specified in this SPA.
Approval Date: November 21, 2012
Effective Date: January 1, 2012