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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 7241 - 7250 of 15783

Oklahoma
This implement a 3% rate increase for Level 1 Licensed Behavioral Health Practitioners in independent practice.
Approval Date: August 20, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement

North Carolina
This is to clarify definitions and procedures in the Estate Recovery Program.
Approval Date: August 17, 2018
Effective Date: October 1, 2018
Topics: Program Administration

Florida
This increases the Personal Needs Allowance for Medicaid residents in institutional settings.
Approval Date: August 17, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement

Alabama
Through this SPA, Alabama implements mental health parity requirements in section 2103(c)(6) of the Social Security Act (the Act) and regulations at 42 CFR 457.496 to ensure that financial requirements and treatment limitations applied to mental health (MH) and substance use disorder (SUD) benefits are no more restrictive than those applied to medical/surgical (M/S) benefits.
Approval Date: August 16, 2018
Effective Date: October 1, 2017

Connecticut
This SPA amends Attachment 4.19-B of the Medicaid State Plan to update the reimbursement methodology for attendant care services provided in the Community First Choice Program pursuant to section 1915(k) of the Social Security Act to conform to the permissible hourly wages for attendants set forth in the applicable collective bargaining agreement. If no collective bargaining agreement is in effect at the time a service is provided, the permissible hourly wages will be in accordance with the most recent collective bargaining agreement.
Approval Date: August 16, 2018
Effective Date: April 1, 2018

Connecticut
This reduces and adjust the payment methodology for Durable Medical Equipment (DME) in order to comply with section 1903(i)(27) of the Social Security Act, as amended by provisions in P.L. 114-255, which limit federal financial participation (FFP) to the amount that Medicare Part B would have paid for specified DME items, incorporating the Medicare Competitive Bidding Program payment amounts.
Approval Date: August 16, 2018
Effective Date: April 1, 2018
Topics: Financing & Reimbursement

Oklahoma
This adds language that clarifies the methodology by which vaccines, other than those offered through the Vaccines for Children (VFC) program, are priced absent a published Medicare price. Vaccines provided through VFC will not be affected by this amendment.
Approval Date: August 16, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement

Oklahoma
This adds Accreditation Commission for Health Care (ACHC) as an additional accreditation option for outpatient behavioral health organizations.
Approval Date: August 16, 2018
Effective Date: September 1, 2018
Topics: Program Administration

South Carolina
This is for elimination of retrospective cost settlements and establish prospective payment rates effective October 1, 2012 for Mental Health Clinic services, Special Needs Transportation services, Family/Early Intervention services, and Preventive Services for Primary Care Enhancement services.
Approval Date: August 16, 2018
Effective Date: October 1, 2012
Topics: Financing & Reimbursement

Arkansas
This provides special consideration to border city university-affiliated pediatric teaching hospitals to utilize cost data in a manner consistent with the method used for identifying cost for private hospital access payments.
Approval Date: August 16, 2018
Effective Date: August 1, 2018
Topics: Financing & Reimbursement