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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 13181 - 13190 of 15720

Idaho
This SPA clarifies that the State does not cover licensed or otherwise state-approved Freestanding Birth Centers as outlined in Section 2301 of the Affordable Care Act.
Approval Date: April 26, 2012
Effective Date: January 1, 2012
Topics: Program Administration

Guam
Provider Screening and Enrollment.
Approval Date: April 26, 2012
Effective Date: January 1, 2012

Washington
This amendment is a technical correction to the Medicaid State plan and makes no program or reimbursement changes.
Approval Date: April 26, 2012
Effective Date: October 1, 2011

Massachusetts
This SPA implemented the provider screening and enrollment provisions of Section 6401(a) of the Affordable Care Act.
Approval Date: April 26, 2012
Effective Date: January 1, 2012

Vermont
This SPA transmitted a proposed amendment to your approved Title XIX State plan to implement Section 6401(a) of the Affordable Care Act . This Affordable Care Act provision amended section 18660) of the Social Security Act to add a new paragraph ''(2) Provider Screening."
Approval Date: April 26, 2012
Effective Date: March 31, 2012

Vermont
This SPA amends the State's approved Title XIX State Plan to reduce the current Medicaid reimbursement methodology for limited distribution specialty pharmacies from average wholesale price (AWP) minus 14.2 percent to 16.5 percent, cover generic over-the-counter drugs when medically necessary without the option of prior authorization for brand name drugs and cover active pharmaceutical ingredient (API) drugs.
Approval Date: April 26, 2012
Effective Date: July 1, 2011

Hawaii
Eliminates references to the Average Wholesale Price and defines how the Estimated Acquisition Cost is determined based on the lesser of the Wholesale Average Cost plus zero percent and increases the pharmacy dispensing fee from $4.67 to $5.00.
Approval Date: April 23, 2012
Effective Date: October 1, 2012
Topics: Financing & Reimbursement

Pennsylvania
This amendment modifies the State's methods regarding reimbursement for readmissions to inpatient facilities.
Approval Date: April 20, 2012
Effective Date: July 1, 2011
Topics: Program Administration

Minnesota
Updated Implementation Date for the Recovery Audit Contractors Program.
Approval Date: April 19, 2012
Effective Date: January 1, 2012

Idaho
These changes are being made to comply with 2011 Idaho Legislative direction in House Bill260. This change is a reduction in adult psychosocial rehabilitation (PSR) service homes.
Approval Date: April 19, 2012
Effective Date: July 1, 2011
Topics: Program Administration