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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 10481 - 10490 of 15783

Delaware
Standards for coverage of organ transplant services by adding "Intestinal transplant" to the list of transplant procedures to reflect long-standing practice.
Approval Date: December 2, 2014
Effective Date: August 1, 2014
Topics: Benefits Program Administration

Louisiana
Increases the dispensing fee from $10.13 to $10.51 per prescription.
Approval Date: December 2, 2014
Effective Date: November 1, 2012
Topics: Financing & Reimbursement Prescription Drugs

Arizona
This SPA updates the State Plan section on third party liability to reflect recent internal changes to third party liability claims processing, including diagnosis & trauma code edits, availability of other insurance coverage, determination of correct billing and other related changes.
Approval Date: December 2, 2014
Effective Date: July 1, 2014
Topics: Program Administration

South Carolina
This SPA updates the coverage criteria for Preventative Services.
Approval Date: December 2, 2014
Effective Date: September 1, 2014
Topics: Program Administration

Alabama
Discontinue the Certified Public Expenditure (CPE) program for State and Non State governmental hospital facilities and to implement plan authority for an Upper Payment Limit (UPL) program for State and Non-State governmental hospitals.
Approval Date: December 2, 2014
Effective Date: October 1, 2013
Topics: Financing & Reimbursement Program Administration

Wisconsin
Outpatient Hospital Rates.
Approval Date: December 2, 2014
Effective Date: January 1, 2014
Topics: Financing & Reimbursement

New Hampshire
Rate increase for personal care services in order to maintain an adequate qualified and stable work force of personal care attendants for Medicaid Beneficiaries.
Approval Date: December 2, 2014
Effective Date: October 6, 2014
Topics: Financing & Reimbursement Program Administration

Utah
Kinship Guardianship Coverage.
Approval Date: December 1, 2014
Effective Date: November 25, 2014
Topics: Benefits Eligibility Program Administration

North Carolina
This SPA establishes that one or more qualified hospitals are determining presumptive eligibility, and that the state is providing coverage for individuals determined presumptively eligible, in accordance with the Affordable Care Act.
Approval Date: December 1, 2014
Effective Date: January 1, 2014

Illinois
This SPA eliminates the add-on reimbursement for delivery of psychiatric rehabilitation services to individuals with mental illness residing in nursing facilities, which was $10 per day.
Approval Date: December 1, 2014
Effective Date: July 1, 2012
Topics: Financing & Reimbursement