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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 7231 - 7240 of 15783

Indiana
This SPA adds reimbursement for the services provided by a community mental health center on or after August 1, 2017 that are enrolled qualified clinics approved by the state, and shall be reimbursed by the Medicaid RBRVs fee schedule, or percentage thereof, of the practitioner employed or contracted with the clinic.
Approval Date: August 22, 2018
Effective Date: August 1, 2017
Topics: Financing & Reimbursement

Maine
This revises reimbursement for inpatient hospital services. Specifically it: 1) adds reimbursement for Long Active Reversible Contraceptives (LARC) during postpartum inpatient hospital stay to provide adequate reimbursement to provider for the device; 2) changes data used to calculate Prospective Interim Payment (PIP) to provide more accuracy; and 3) further revises the state's fourteen day readmission protocol which was approved under TN 14-0003 and further amended under TN 15- 0010.
Approval Date: August 21, 2018
Effective Date: November 14, 2017
Topics: Financing & Reimbursement

Utah
This SPA updates the inflation and utilization trend for the required outpatient hospital upper payment limit (UPL) demonstration as well as updates the language for the private hospital supplemental payments.
Approval Date: August 21, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement

New York
An increase in the Fee-For-Service nursing home per diem rate by 17% for select nursing homes.
Approval Date: August 21, 2018
Effective Date: June 22, 2018
Topics: Financing & Reimbursement

Montana
This updates the bundled psychiatric service rate for Psychiatric Residential Treatment Facilities (PRFTs) services.
Approval Date: August 21, 2018
Effective Date: July 10, 2018
Topics: Financing & Reimbursement

Idaho
This explains changes the inpatient hospital upper payment limit (UPL) demonstration method from diagnosis related group (DRG) based to cost-based for non-state government owned (NSGO) and private hospitals.
Approval Date: August 21, 2018
Effective Date: June 6, 2018
Topics: Financing & Reimbursement

California
Regarding adding nonmedical transportation (NMT) services for all eligible beneficiaries to travel to and from covered Medi-Cal services and updates the nonemergency medical transportation description.
Approval Date: August 21, 2018
Effective Date: July 1, 2017
Topics: Program Administration

Michigan

This SPA allows for nursing facility quality incentive initiative. A quality measure initiative (QMI) payment is established for class i and class iii nursing facilities.

Approval Date: August 20, 2018
Effective Date: October 1, 2017
Topics: Health Services Initiatives

Washington
This SPA corrects an error associated with the approval of WA SPA 18-0003.
Approval Date: August 20, 2018
Effective Date: January 1, 2018
Topics: Program Administration

Montana
This removes the fee schedule for Service 19c. Targeted Case Management (TCM) Services for Individuals with Developmental Disabilities (DD) Age 16 and Over or Who Reside in a DD Children's Group Home State Plan from MT's 4.19 B Intro Page for non-Institutional services. The date of the removal from the Intro page will be June 1, 2018.
Approval Date: August 20, 2018
Effective Date: June 1, 2018
Topics: Financing & Reimbursement