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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 12951 - 12960 of 15756

Michigan
Policy and Methods for Establishing Payment Rates.
Approval Date: August 8, 2012
Effective Date: December 1, 2012

Texas
Clarifies Orthotic and Prosthetic Services Available Under EPSDT Recipients Under Age 21.
Approval Date: August 8, 2012
Effective Date: June 1, 2012

California
Provides for Supplemental Payments up to cost, funded by certified funded expenditures, for free-standing governmentally-owned and operated clinics.
Approval Date: August 8, 2012
Effective Date: October 14, 2006

New York
Termination of Targeted Case Management Programs: TASA, CONNECT and NBA. (FMAP = 50%) *Annual Savings Breakdown; TASA=($3,933,259); CONNECT=($152,499); NBA=($123,188).
Approval Date: August 7, 2012
Effective Date: December 1, 2011

Minnesota
Creates Integrated Care Model for Health Care Delivery Systems.
Approval Date: August 6, 2012
Effective Date: January 1, 2013

New York
Implements Trend Factor No Greater Than Zero Percent for Non-Institutional Services.
Approval Date: August 6, 2012
Effective Date: April 1, 2011

Vermont
Changes the prior authorization procedures for physical therapy, speech therapy, and occupational therapy services for children under the age of 21.
Approval Date: August 6, 2012
Effective Date: May 1, 2012

Rhode Island
This SPA approves the transition of the single -state agency designation from the Department or Human services (DHS) to the Executive Office of Health and Human Services (EOHHS).
Approval Date: August 2, 2012
Effective Date: July 1, 2011
Topics: Program Administration

Connecticut
This SPA proposed to amend the maximum allowable cost for selected multi-source brand and generic drugs to range from average wholesale price (A WP) minus 72 percent to step down tiers through A WP minus 20 percent based on meeting specific invoice pricing criteria.
Approval Date: August 2, 2012
Effective Date: November 1, 2011

North Carolina
This amendment proposes to clarify the description of prescribed drugs, revise the reimbursement methodology for North Carolina Estimated Acquisition Cost (NCEAC) for prescribed drugs and establish a 4 rate tier generic dispensing fee structure for reimbursement.
Approval Date: August 2, 2012
Effective Date: February 1, 2012