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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 7131 - 7140 of 15780

Mississippi
Allow RHC's to receive reimbursement outside of the encounter rate for the administration of physician administered drugs that are reimbursed through the pharmacy benefits.
Approval Date: September 30, 2018
Effective Date: November 1, 2018
Topics: Benefits Financing & Reimbursement

Mississippi
Reimbursement for FQHC's outside of the encounter rate for the administration, insertion and removal of certain PADs that are reimbursed through the pharmacy benefit.
Approval Date: September 30, 2018
Effective Date: July 1, 2018
Topics: Benefits Financing & Reimbursement

New Hampshire
This amends the NH Title XIX State Plan cost sharing for the new adult group to align with cost sharing for other Medicaid eligibility categories.
Approval Date: September 28, 2018
Effective Date: January 1, 2019
Topics: Financing & Reimbursement

North Dakota
This adds the eligibility group described at section 1902(a)(lO)(A)(ii)(Vl) of the Social Security Act ("Act") and implemented at 42 CFR §435.217 of the regulations to North Dakota Medicaid's State Plan. This also proposed, under the authority of section 1902(r)(2) of the Act, to disregard parental resources from consideration in determining eligibility for children under that eligibility group.
Approval Date: September 28, 2018
Effective Date: July 1, 2018

Michigan
Implements Health Homes for Opioid/Substance Use Disorder targeted conditions as authorized under Section 2703 of the Patient Protection and Affordable Care Act.
Approval Date: September 28, 2018
Effective Date: October 1, 2018

Iowa
This adjusts the professional dispensing fee from $10. 02 to $10. 07 per prescription, based on a recent cost of dispensing survey of lowa Medicaid enrolled pharmacy providers.
Approval Date: September 28, 2018
Effective Date: November 1, 2018
Topics: Financing & Reimbursement Prescription Drugs

Minnesota
Proposes to cover prenatal and postpartum home visits by a Public Health Nurse or a RN under the supervision of a Public Health Nurse.
Approval Date: September 28, 2018
Effective Date: October 1, 2018

Illinois
This increases the Medicaid per diem rate for facilities with more than 16 licensed beds licensed by the Department of Public Health under the ID/DD Community Care Act located in the Department of Public Health's Planning Area 7-B.
Approval Date: September 27, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement

Mississippi
This modifies the Graduate Medical Education (GME) Innovations Grant agreement to reflect a change in hospital partnership and an increase in the agreement amount funding available to providers in the state of Michigan providing accredited psychiatric residency training.
Approval Date: September 27, 2018
Effective Date: July 1, 2018

Rhode Island
This remove a 10% payment withhold from the Health Home reimbursement methodology.
Approval Date: September 27, 2018
Effective Date: June 1, 2018
Topics: Financing & Reimbursement Health Homes