An official website of the United States government
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
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.
Summary: The state plan increases the reimbursement rates for physician services rendered by health plans in the coordinated care networks as well as fee-for-service visits to meet compliance with Section 1202 of the Patient Protection and Affordable Care Act (PPACA) and federal regulations.
Summary: This state plan amendment revises the provisions governing coordinated care networks to include pharmacy services as a covered service under the BAYOU HEALTH Program for recipients enrolled in pre-paid health plans.
Summary: This state plan amendment removes the provisions for dental services rendered to Medicaid eligible pregnant women in order to terminate the program as an optional covered service under the Medicaid State Plan.
Summary: This state plan amendment reduces the reimbursement rates for dental services rendered to Medicaid eligible pregnant women in order to avoid a budget deficit in the State of Louisiana.
Summary: This state plan amendment adds language to include additional substance abuse screenings for Medicaid eligible pregnant women in the event of miscarriage or fetal death within the 270 day pregnancy period. The plan also lists the LaHART system as the State's screening and assessment tool for these services.
Summary: Under this SPA, the state proposes to revise the current pharmacy reimbursement methodology for the ingredient cost from average wholesale price (AWP) minus 13% for independent pharmacies and AWP minus 15% for chain pharmacies to average acquisition cost (AAC).
Summary: This state plan amendment proposes a supplemental payment to physicians and other eligible professional services practitioners affiliated with the Tulane University School of Medicine.
Summary: Allows the State to implement immediate auto-assignment of pregnant women whose Medicaid eligibility is limited to prenatal, delivery, and post-partum services to the Bayou Health Program.
