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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 13101 - 13110 of 15726

Wisconsin
This amendment revises payment methodologies for inpatient hospital services. Specifically, this amendment eliminates the length of stay outlier payment; clarifies that Medicare cost report data is obtained through the Health Cost Reporting Information System (HCRIS) maintained by the Center for Medicare and Medicaid Services (CMS); increases the standard DRG group rate; increases the "trimpoint" amount for hospitals to qualify for a cost outlier payment; proposes supplemental disproportionate share hospital (DSH) payments for State, County and Private hospitals; creates a second level of supplemental payments to essential access city hospitals; increases the amount of inpatient access payments to acute care, children's, rehabilitation, and critical access hospitals.
Approval Date: May 25, 2012
Effective Date: July 1, 2011
Topics: Financing & Reimbursement

Illinois
Pharmacy services - Wholesale acquisition cost reimbursement methodology.
Approval Date: May 25, 2012
Effective Date: February 1, 2012

Iowa
This amendment eliminates graduate medical education (GME) payments to out-of-State hospitals, reduces GME payments to in-State hospitals, and imposes payment reductions for health care-acquired conditions per section 2702 of the Affordable Care Act.
Approval Date: May 25, 2012
Effective Date: September 1, 2011

Ohio
Disproportionate Share Hospital (DSH) Program: Redistribution post DSH audit.
Approval Date: May 25, 2012
Effective Date: October 1, 2011

New York
This amendment will also carve out medication costs from the inpatient PR TF rates.
Approval Date: May 25, 2012
Effective Date: July 1, 2011

Oklahoma
The plan amendment sunsets provider type Certified Alcohol and Drug Counselor from qualified providers for certain outpatient psychotherapy over a period of two years.
Approval Date: May 24, 2012
Effective Date: July 1, 2012

Oklahoma
Pharmacy Pricing Benchmark Methodology.
Approval Date: May 24, 2012
Effective Date: March 1, 2012

Massachusetts
This SPA implemented Section 4107 of the Affordable Care Act regarding coverage for tobacco cessation services for pregnant women.
Approval Date: May 24, 2012
Effective Date: July 1, 2011

Wisconsin
Pharmacy reimbursement.
Approval Date: May 24, 2012
Effective Date: October 1, 2011

Washington
This SPA brings the state into compliance with section 4107 of the Patient Protection and Affordable Care Act to provide for Medicaid coverage of comprehensive tobacco cessation services for pregnant women, including both counseling and pharmacotherapy, without cost sharing.
Approval Date: May 24, 2012
Effective Date: July 1, 2011