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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 6961 - 6970 of 15780

New York
Authorizes hospital outpatient supplemental payments to eligible voluntary sector owned or operated general hospitals, excluding government general hospitals.
Approval Date: November 27, 2018
Effective Date: April 1, 2016
Topics: Financing & Reimbursement

Connecticut
Revises the Ambulatory Surgical Center fee schedule. Adds HCPCS code 41899 (Unlisted procedure, dentoalveolar) to the Ambulatory Surgical Center fee schedule, to expand access to dental care.
Approval Date: November 26, 2018
Effective Date: July 1, 2017

Oklahoma
This amendment was submitted to apply a three percent (3%) increase to the fee-for-service fee schedule for the following services.
Approval Date: November 26, 2018
Effective Date: October 1, 2018
Topics: Financing & Reimbursement

Illinois
Healthcare and Family Services (IHFS) will not implement a single preferred drug list. IHFS will remove references to single PDL from the Supplemental Rebate Agreement.
Approval Date: November 26, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement

Connecticut
Revise the Federally Qualified Health Clinic (FQHC) reimbursement provisions to add an alternative payment methodology for Indian Health Services (I.H.S.) tribal clinics, pursuant to Section 1902(bb)(6) of the Social Security Act.
Approval Date: November 26, 2018
Effective Date: July 1, 2017
Topics: Financing & Reimbursement

Montana
This amendment revises the effective date for only those fee schedules for services that are based upon the Medicare fee.
Approval Date: November 26, 2018
Effective Date: January 1, 2019
Topics: Financing & Reimbursement

California
Will add pharmacists under the "Other Licensed Practitioner" provider category so that Medi-Cal may reimburse these providers for services for already-covered medications.
Approval Date: November 26, 2018
Effective Date: April 1, 2019
Topics: Financing & Reimbursement

Kansas
Received Kansas' State Plan Amendment (SP A) transmittal# 18-0011, which documents the payment methodology for Reserve Days at Psychiatric Residential Treatment Facilities (PRTFs).
Approval Date: November 23, 2018
Effective Date: July 1, 2018
Topics: Program Administration

Iowa
The purpose of the SPA is to implement a statewide fee schedule reimbursement for case management services in accordance with 2018 Iowa Acts, Senate File 2418, Section 132.
Approval Date: November 23, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement

Iowa
Pharmacy co-payment to $1. 00 per prescription or refill.
Approval Date: November 22, 2018
Effective Date: December 1, 2018
Topics: Financing & Reimbursement