U.S. flag

An official website of the United States government

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 7281 - 7290 of 15783

Pennsylvania
Brings Pennsylvania into compliance with the reimbursement requirements in the Covered Outpatient Drug final rule with comment period (CMS-2345-FC).
Approval Date: July 30, 2018
Effective Date: April 1, 2017
Topics: Financing & Reimbursement

Illinois
Extends the psychiatric add-on payment for physicians, advanced practice nurses and community mental health practitioners.
Approval Date: July 27, 2018
Effective Date: July 1, 2018
Topics: Program Administration

New York
This amendment reallocates certain Disproportionate Share Hospital (DSH) payments that would exceed the hospital-specific DSH limit, defines two distinct DSH state plan rate years (SPRY), clarifies some existing DSH provisions and eliminates other obsolete DSH provisions.
Approval Date: July 26, 2018
Effective Date: January 1, 2011
Topics: Financing & Reimbursement

New York
This amendment continues to provide for supplemental payments to certain non-state government nursing homes.
Approval Date: July 26, 2018
Effective Date: April 1, 2018
Topics: Financing & Reimbursement

Utah
This State Plan Amendment increases the monthly nursing visit limit for hemophilia patients and requires prior authorization for additional visits. It also clarifies reimbursement methodology for covered outpatient drugs, removes NADAC as a component of the UMAC.
Approval Date: July 26, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement Program Administration

New York
This amendment provides temporary Vital Access Provider / Safety Net Provider (VAP/SNP) enhanced payments to Elderwood at Northcreek Nursing Facility.
Approval Date: July 26, 2018
Effective Date: April 1, 2018
Topics: Financing & Reimbursement

Texas
This amendment updates the physicians and other practitioners' schedules.
Approval Date: July 26, 2018
Effective Date: June 1, 2018
Topics: Program Administration

Michigan
This SPA assists with the improved access to home health care and durable medical equipment under home health services.
Approval Date: July 26, 2018
Effective Date: July 1, 2018

Ohio
Coverage & Payment: Dental Services.
Approval Date: July 26, 2018
Effective Date: July 1, 2018
Topics: Benefits Dental Financing & Reimbursement

Massachusetts
This is changes to the reimbursement methodology for private psychiatric hospital and substance abuse treatment hospital services.
Approval Date: July 26, 2018
Effective Date: October 1, 2017
Topics: Financing & Reimbursement