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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 7091 - 7100 of 15780

South Carolina
Removes the Integrated Personal Care (IPC) program from the Medicaid State Plan.
Approval Date: October 15, 2018
Effective Date: July 1, 2013
Topics: Program Administration

Nevada
A minor technical correction to the reimbursement methodology for evaluation and management.
Approval Date: October 15, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement

California
Implements a Behavioral Health Home Program (HHP).
Approval Date: October 12, 2018
Effective Date: January 1, 2019

Vermont
Extends the timeframe for Drug Utilization Review Board drug class reviews from annually to at least every two years.
Approval Date: October 12, 2018
Effective Date: July 18, 2018
Topics: Prescription Drugs Program Administration

California
Expands the HHP into the counties of Riverside and San Bernardino for the population criterion of chronic physical conditions and substance use disorder (SUD).
Approval Date: October 12, 2018
Effective Date: January 1, 2019
Topics: Program Administration

Louisiana
Amended the provisions governing the reimbursement methodology for nursing facilities.
Approval Date: October 11, 2018
Effective Date: July 5, 2018
Topics: Financing & Reimbursement

Mississippi
Long-Term Care (LTC) Updates #2 is being submitted to allow the Division of Medicaid to (1) revise the number of allowed therapeutic leave days for nursing facilities (NFs) and intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs), (2) remove stock transactions as a change in ownership assets, (3) clarify the provider appeals process to include reconsideration prior to an administrative appeals request, (4) remove MDS submissions as appealable,(5) restrict providers from entering or modifying hospital and therapeutic leave days via the web portal after the corresponding quarter close cutoff and (6) update the table of contents to reflect changes in MS SPA 15-004.
Approval Date: October 11, 2018
Effective Date: July 1, 2018
Topics: Benefits Program Administration

Iowa
This implements an annual benefit maximum (ABM) of $1,000 per member/per fiscal year beginning September 1, 2018, and each fiscal year thereafter.
Approval Date: October 11, 2018
Effective Date: September 1, 2018
Topics: Financing & Reimbursement

Iowa
To remove the name of the actuary contractor, and the specific counties covered by the Programs for All-Inclusive Care for the Elderly (PACE).
Approval Date: October 11, 2018
Effective Date: July 1, 2018
Topics: Program Administration

Oklahoma
Increases the rate by 3 percent for inpatient psychiatric hospitals.
Approval Date: October 11, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement