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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 7291 - 7300 of 15783

Washington
This amendment identified the threshold dollar amount the Health Care Authority (HCA) uses to pursue recovery of medical services claims that were paid by Medicaid when a commercial insurance had primary responsibility for payment.
Approval Date: July 25, 2018
Effective Date: July 1, 2018
Topics: Program Administration

Washington
Provides a one-year (for SFY 2019) rate enhancement for the inpatient and outpatient hospital services of qualifying State and NSGO sole community hospitals by increasing the hospital specific conversion factor to 1.50 from the current 1.25.
Approval Date: July 25, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement

Arkansas
This amendment proposes to delete Hysterectomy, Appendectomy, Uncomplicated Pediatric Pneumonia and Urinary Tract Infection Episodes of Care.
Approval Date: July 25, 2018
Effective Date: July 1, 2018

New York
This amendment will provide temporary quarterly supplemental payments to Strong Memorial Hospital.
Approval Date: July 25, 2018
Effective Date: April 1, 2018
Topics: Financing & Reimbursement

Connecticut
This SPA amends Attachment 4.19-B to incorporate various 2016 Healthcare Common Procedure Coding System (HCPCS) changes (additions, deletions and description changes) to the physician fee schedule.
Approval Date: July 25, 2018
Effective Date: January 1, 2016
Topics: Program Administration

South Carolina
This state plan modifies the frequency of the third party liability (TPL) health recovery cycle from quarterly to monthly.
Approval Date: July 24, 2018
Effective Date: July 1, 2018
Topics: Program Administration

New York
Amends and updates the State's APG system for Freestanding Clinic services.
Approval Date: July 24, 2018
Effective Date: January 1, 2018
Topics: Program Administration

New York
This amendment updates the direct price peer group limit used in setting nursing facility (NF) per-diem rates.
Approval Date: July 24, 2018
Effective Date: April 1, 2018
Topics: Financing & Reimbursement

Colorado
Reimbursement update for DME Rates.
Approval Date: July 23, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement

Oklahoma
To amend the state plan allowing the discontinuation of a recovery audit contractor (RAC) for a period of two years from the approved effective date.
Approval Date: July 20, 2018
Effective Date: April 1, 2018
Topics: Program Administration