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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 7061 - 7070 of 15780

Mississippi
This removes the five percent (5%) assessment of outpatient hospital services, clarify the Outpatient Prospective Payment System (OPPS) payment methodology, and add the reimbursement methodology for Long Acting Reversible Contraceptives (LARCs).
Approval Date: October 22, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement

Montana
This restores OLP denturist services for adults.
Approval Date: October 22, 2018
Effective Date: October 1, 2018

Missouri
Revised the Developmentally Disabled Targeted Case Management (TCM) provider qualifications and added conflict free requirements.
Approval Date: October 22, 2018
Effective Date: July 1, 2018
Topics: Program Administration

Montana
Reimbursement update for Dental Services.
Approval Date: October 22, 2018
Effective Date: October 1, 2018
Topics: Dental Financing & Reimbursement

District of Columbia
Supplemental payments in Fiscal Year 2019 to Medicaid-enrolled physician group practices.
Approval Date: October 22, 2018
Effective Date: October 1, 2018
Topics: Financing & Reimbursement

Ohio
Coverage & Limitations: Physical Therapy and Related Services.
Approval Date: October 22, 2018
Effective Date: October 1, 2018
Topics: Program Administration

New Mexico
Proposes to add a Substance Use Disorder (SUD) Continuum of Services to the New Mexico State plan.
Approval Date: October 22, 2018
Effective Date: January 1, 2019
Topics: Prescription Drugs State Plan Factsheet

New York
Revises the Ambulatory Patient Group methodology for hospital-based clinic and ambulatory surgery services, including emergency room services.
Approval Date: October 19, 2018
Effective Date: July 1, 2016
Topics: Financing & Reimbursement

New York
Updates the State's APG system for Freestanding Clinic services.
Approval Date: October 19, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement Program Administration

Nevada
Updates for the Basic Skills Training rate.
Approval Date: October 18, 2018
Effective Date: January 1, 2019
Topics: Financing & Reimbursement