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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 12651 - 12660 of 15756

Colorado
Supplemental Medicaid Inpatient and DSH Payments Revised.
Approval Date: December 14, 2012
Effective Date: July 1, 2012
Topics: Financing & Reimbursement

Oklahoma
This state plan amendment requests revision of reimbursement methodology for End Stage Renal Disease (ESRD) to reflect Medicare's current bundled payment structure.
Approval Date: December 13, 2012
Effective Date: July 1, 2012
Topics: Financing & Reimbursement

North Carolina
This amendment proposes to revise the payment methodology for nursing facility services.
Approval Date: December 13, 2012
Effective Date: April 1, 2012
Topics: Financing & Reimbursement

Virginia
This SPA modifies Attachments 4.19-A and 4.19-D of Virginia's Title XIX State Plan. Specifically, SPA 12-11 modifies reimbursement to establish inflation rates applied to operating rates, and escalation factors applied to rate ceilings, as well as setting the nursing facility rental floor for 2013.
Approval Date: December 13, 2012
Effective Date: July 1, 2012

Pennsylvania
The amendment adds supplemental payments to nursing facilities that provide higher percentages of ventilator care to Medicaid patients.
Approval Date: December 13, 2012
Effective Date: July 1, 2012

New Hampshire
This amendment was submitted to provide supplemental payments in calendar year 2010 to non-public, non-federal acute care and rehabilitation outpatient hospitals to increase payments. This SPA also modified state plan payment methodologies for outpatient hospital reimbursement to identify the actual percentage of costs that would constitute the final rate.
Approval Date: December 13, 2012
Effective Date: November 19, 2010
Topics: Financing & Reimbursement

New Hampshire
This amendment added a prior authorization requirement for certain non-emergent, high cost diagnostic x-ray services.
Approval Date: December 13, 2012
Effective Date: August 1, 2006

New Hampshire
This amendment modifies reimbursement methodologies for inpatient hospital service providers. Specifically it redesigns the Disproportionate Share Hospital (DSH) reimbursement methodology to prioritize payments to specific types of hospitals and adds provisions for Medicaid inpatient hospital supplemental payments for calendar year 2010 to mitigate the potential impact on cash flow for hospitals with lower uncompensated care cost due to the proposed changes in DSH payment method.
Approval Date: December 13, 2012
Effective Date: November 19, 2010
Topics: Financing & Reimbursement

New Hampshire
This amendment modifies the reimbursement methodology for inpatient hospital services.
Approval Date: December 13, 2012
Effective Date: April 1, 2010
Topics: Financing & Reimbursement

New Hampshire
This amendment modifies the reimbursement methodology for inpatient hospital services.
Approval Date: December 13, 2012
Effective Date: March 1, 2010
Topics: Financing & Reimbursement