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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 14181 - 14190 of 15708

Oklahoma
Revises the plan language regarding tribal consultation and removes the marketing provision of MCOs, PIHPS, PAHPS, and or PCCM programs.
Approval Date: March 25, 2011
Effective Date: December 1, 2010
Topics: Program Administration

Indiana
The SPA seeks to move select 1915(b) pulations to State Plan services under 1932(a).
Approval Date: March 25, 2011
Effective Date: October 1, 2010

Maryland
Prohibits payments for items or services provided under the Medicaid State Plan or under a Medicaid Waiver to any financial institution or entity located outside of the U.S.
Approval Date: March 25, 2011
Effective Date: January 1, 2011

North Carolina
Addresses the requirements regarding Estate Recovery per Section 115 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) by encouraging dual eligible beneficiaries to fully utilize Medicare cost-sharing benefits available through the Medicare Savings Program.
Approval Date: March 25, 2011
Effective Date: October 1, 2010

Connecticut
Prior authorization requirements for hospital dental clinics and freestanding dental clinics for identified dental services and requirements for documentation of medical necessity for high cost procedures by dental clinics.
Approval Date: March 24, 2011
Effective Date: November 1, 2010
Topics: Financing & Reimbursement

Delaware
Updates this SPA regarding Reasonable Classifications of Individuals Under 21, 20, 19 and 18.
Approval Date: March 24, 2011
Effective Date: January 1, 2011

Guam
Covered Services and Transportation.
Approval Date: March 24, 2011
Effective Date: January 1, 2011

Georgia
This amendment allows the Georgia Medicaid program to establish programs to contract with one or more Medicaid RACs for the purpose of identifying underpayments and overpayments and recouping overpayments under the State Plan and under any waiver of the State Plan with respect to all services. All Medicaid RACs must be paid on a contingent basis for collecting overpayments.
Approval Date: March 24, 2011
Effective Date: January 1, 2012

California
Incorporates the State Eligibility Option for Family Planning Services.
Approval Date: March 24, 2011
Effective Date: July 1, 2010
Topics: Benefits Eligibility Program Administration

Texas
Reduces 1 Percent Reimbursement for Medicaid Providers of High Risk Pregnant Women.
Approval Date: March 24, 2011
Effective Date: February 1, 2011