U.S. flag

An official website of the United States government

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 14811 - 14820 of 15693

Arkansas
Language Changes Due to Health Care Reform and Redefining Calculation Federal Upper Limit.
Approval Date: August 12, 2010
Effective Date: June 1, 2010

Connecticut
This amendment proposed to amend the State's approved Title XIX State Plan to reduce the maximum allowable cost paid for selected multi-source drugs from average wholesale price (AWP)-40% to AWP-45 %; require pharmacy providers to obtain prior authorization for certain drugs that are either high cost, subject to misuse or subject to excessive or inappropriate utilization, as determined by the State; change the prior authorization requirements for early refills from 75% to 85% of days supply; and allow the dispensing of an automatic fourteen (14) day supply of a drug when no prior authorization has been requested and granted.
Approval Date: August 12, 2010
Effective Date: October 1, 2009

Alabama
Expands the Personal Choices Program by adding Mobile, Escambia, and Baldwin counties as additional coverage areas within the State of Alabama.
Approval Date: August 11, 2010
Effective Date: July 1, 2010

New Mexico
Exempts Medicare Cost-Sharing Benefits Under Medicare Savings Program from Recovery.
Approval Date: August 11, 2010
Effective Date: April 1, 2010

Alabama
Allows Establishment of Reimbursement Through Use of Electronic Benefit Transfer System.
Approval Date: August 11, 2010
Effective Date: July 1, 2010

Pennsylvania
Additional Class of Disproportionate Share Payments.
Approval Date: August 10, 2010
Effective Date: May 23, 2010

Louisiana
Reduces the nursing facilities rate by 10.52 percent.
Approval Date: August 10, 2010
Effective Date: July 1, 2010
Topics: Financing & Reimbursement

Texas
Revises the reimbursement methodology for nursing facilities to indicate that payment rates effective September 1, 2010, will be equal to rates in effect August 31, 2010, less one percent.
Approval Date: August 10, 2010
Effective Date: September 1, 2010
Topics: Financing & Reimbursement

Texas
Implements a one percent payment reduction for Medicaid services provided by non-state freestanding psychiatric facilities.
Approval Date: August 10, 2010
Effective Date: September 1, 2010
Topics: Financing & Reimbursement

Illinois
Methods and standards for establishing inpatient rates for hospital reimbursement - Outlier Payments.
Approval Date: August 10, 2010
Effective Date: January 1, 2008