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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 11881 - 11890 of 15777

Kentucky
Removes the four prescription limit for the pharmacy benefit and also removes the Behavioral Pharmacy Management Program from the State Plan as the program no longer exists.
Approval Date: November 6, 2013
Effective Date: January 1, 2014
Topics: Benefits Prescription Drugs

Rhode Island
Opioid Treatment Program Health Home Services.
Approval Date: November 6, 2013
Effective Date: July 1, 2013

Pennsylvania
Prescribed Drugs Supplemental Drug Rebate Agreement.
Approval Date: November 6, 2013
Effective Date: October 1, 2013
Topics: Financing & Reimbursement Prescription Drugs

Iowa
The state is proposing to modify payment for intermittent services and private duty nursing services by the home health agencies.
Approval Date: November 6, 2013
Effective Date: July 1, 2013

Michigan
Revises the National Medicaid Pooling Initiative Supplemental Rebate Agreement.
Approval Date: November 6, 2013
Effective Date: October 1, 2013
Topics: Program Administration

Ohio
Face-to-face encounter provisions under the home health benefit.
Approval Date: November 6, 2013
Effective Date: February 1, 2011

Illinois
Revises Methodologies for Hospital Outpatient Services.
Approval Date: November 4, 2013
Effective Date: June 10, 2012
Topics: Program Administration

Colorado
Includes MAGI-equivalent federal poverty levels as converted from the original CO CHIP SPA #12.
Approval Date: November 2, 2013
Effective Date: January 1, 2012

Wisconsin
Incorporates MAGI-Based Income Methodologies.
Approval Date: November 1, 2013
Effective Date: January 1, 2014
Topics: Financing & Reimbursement

Washington
Adds pregnant teens as an optional reasonable classification of individuals to the Medicaid state plan and disregards all income for this group.
Approval Date: November 1, 2013
Effective Date: November 1, 2013
Topics: Benefits Eligibility Program Administration