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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 13341 - 13350 of 15759

Pennsylvania
This amendment adds language that allows Pennsylvania to recover overpayments of disproportionate share (DSH) payments that exceed a hospital's specific DSH limit as defined by section 1923(g) of the Social Security Act.
Approval Date: March 6, 2012
Effective Date: October 1, 2011
Topics: Financing & Reimbursement Program Administration

Nebraska
Which proposes to reduce the fee schedule rates by 2.5% with a proposed effective date of July 1, 2011.
Approval Date: March 6, 2012
Effective Date: July 1, 2011

Nebraska
Which proposes to reduce the fee schedule rates for clinical laboratory services by 2.5% with a proposed effective date of July 1, 2011.
Approval Date: March 6, 2012
Effective Date: July 1, 2011

Nebraska
Which proposes to reduce the fee schedule rates for outpatient hospital and lab services by 2.5% with a proposed effective date of July 1, 2011.
Approval Date: March 6, 2012
Effective Date: July 1, 2012

Nebraska
Proposes to reduce the fee schedule rate for physician services by 2.5% with a proposed effective date of July 1, 2011.
Approval Date: March 6, 2012
Effective Date: July 1, 2012

New York
APGs Ancillary Services.
Approval Date: March 6, 2012
Effective Date: September 1, 2009

Wyoming
Modifies the reimbursement methodology necessary to comply with CMS regulations specific for provider preventable conditions.
Approval Date: March 6, 2012
Effective Date: October 1, 2011

Nebraska
Increase in co-payments.
Approval Date: March 6, 2012
Effective Date: October 24, 2011

Florida
This SPA proposed to make the Wholesale Acquisition Cost (WAC) based reimbursement calculation equivalent with the current Average Wholesale Price (AWP) based calculation.
Approval Date: March 5, 2012
Effective Date: January 1, 2012
Topics: Financing & Reimbursement

South Carolina
This SPA proposes to change the Medicaid reimbursement for covered outpatient prescriptions to average wholesale price (AWP) minus 16 percent and the dispensing fee to $3.00 in the Prescribed Drug section of the State plan to be consistent with the same reimbursement methodology and dispensing fee recently approved under South Carolina Frontis SPA 11-011.
Approval Date: March 5, 2012
Effective Date: November 1, 2011
Topics: Financing & Reimbursement