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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 7551 - 7560 of 15860

California
Change the Programs of All-Inclusive Care for the Elderly (PACE) rate development methodology from a percent of fee-for-service (FFS) costs to an experience-based rate methodology that uses PACE organization cost experience, encounter data and other data to set rates.
Approval Date: May 17, 2018
Effective Date: January 1, 2018

New Hampshire
Substance Use Disorder (SUD) Treatment and Recovery Support Services, State Owned, License Exempt Rehabilitative Services.
Approval Date: May 16, 2018
Effective Date: July 1, 2018

Maryland
The purpose of this SPA is to add coverage for adult hearing aids and cochlear implants.
Approval Date: May 16, 2018
Effective Date: July 1, 2018

Washington
To transition another region (Grant, Chelan and Douglas Counties) into Fully Integrated Managed Care.
Approval Date: May 16, 2018
Effective Date: January 1, 2018

Virginia
This SPA proposes to permit residents of nursing facilities to deduct the costs of limited specific dental procedures from their payments towards the costs of their nursing facility care. Nursing facility residents shall be limited to deducting the following dental procedures: (i) routine exams and xrays, and dental cleansing twice yearly; (ii) full mouth x-rays once every three years; and (iii) deductions for extractions and fillings shall be permitted only if medically necessary as determined by the department.
Approval Date: May 16, 2018
Effective Date: July 1, 2018

Iowa
This amendment proposes to revise Iowa's Medicaid Supplemental Drug Rebate Agreement, along with removing a nonprescription nicotine replacement therapy from Iowa's excludable drug category on the state plan pages.
Approval Date: May 16, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement Prescription Drugs

Texas
This SPA updates the section of the State Plan that addresses the State Medicaid Supplemental Drug Rebate Agreements.
Approval Date: May 15, 2018
Effective Date: February 15, 2018

Virginia
This SPA replaces the current Level of Functioning (LOF) survey with the Virginia Individual Developmental Disabilities Eligibility Survey standards for individuals seeking Intermediate Care Facilities for Individuals with Intellectual Disabilities services. By using the VIDES standards for institutional care, the Commonwealth is restoring the consistency of applied functional standards for these individuals regardless of whether they obtain their care in the communities via a waiver or in ICF/IID institutions.
Approval Date: May 15, 2018
Effective Date: May 1, 2018

Vermont
This SPA implements targeted case management for children receiving services pursuant to an IEP and for children receiving services pursuant to an IFSP.
Approval Date: May 14, 2018
Effective Date: April 1, 2018

Rhode Island
This eligibility SPA increases the Medically Needy Income Limits for 2018.
Approval Date: May 14, 2018
Effective Date: January 1, 2018
Topics: Eligibility Financing & Reimbursement