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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 7391 - 7400 of 15783

New York
The amendment proposes to apply a Medicaid incentive payment to certain evaluation and management codes for eligible Advance Primary Care (Freestanding Clinics) who obtain and maintain recognition as an advanced care practitioner in New York's statewide Advanced Primary Care (APC) medical home model.
Approval Date: June 14, 2018
Effective Date: January 1, 2017
Topics: Financing & Reimbursement

New York
The amendment proposes to apply a Medicaid incentive payment to certain evaluation and management codes for eligible Advance Primary Care (Federally Qualified Health Centers) who obtain and maintain recognition as an advanced care practitioner in New York's statewide Advanced Primary Care (APC) medical home model.
Approval Date: June 14, 2018
Effective Date: January 1, 2017
Topics: Financing & Reimbursement

Nebraska
Implements a change in the state's cost effectiveness formula for its premium assistance program and to expand the state's premium assistance program to include individual health insurance.
Approval Date: June 14, 2018
Effective Date: January 1, 2018
Topics: Benefits Financing & Reimbursement Program Administration

New Jersey
Implementation of NJ Family Care 1115 Demonstration Waiver as it pertains to guardian commission associated with personal needs allowance in the post eligibility treatment of income.
Approval Date: June 14, 2018
Effective Date: March 1, 2018
Topics: Program Administration

South Carolina
This SPA provides for the following: adding one private nursing facility to receive a supplemental payment to cover the cost of a mandatory evacuation of patient due to a hurricane; add coverage of Non-Emergence Medical Transportation (NEMT) to nursing facility services; provide an add-on to the per diem rate to pay for the NEMT services; and eliminate the occupancy required for replacement facilities for the first six months of operations.
Approval Date: June 14, 2018
Effective Date: January 1, 2018
Topics: Financing & Reimbursement

Connecticut
This is submitted to add clarifying updates to the Person-Center Medical Homes (PCMH+) program and update dental coverage limits.
Approval Date: June 14, 2018
Effective Date: January 1, 2018

Kentucky
This SPA modifies the state's payment for service provided in nursing facility brain injury units.
Approval Date: June 14, 2018
Effective Date: September 1, 2018
Topics: Financing & Reimbursement

Kansas
This amendment modif\u00ECes the readmission policy for inpatient hospital care after discharge.
Approval Date: June 14, 2018
Effective Date: January 1, 2018
Topics: Benefits Program Administration

Wisconsin
Former Foster Care Youth.
Approval Date: June 13, 2018
Effective Date: January 1, 2018

Alabama
This SPA modifies the DME reimbursement in accordance with the 21st Century Cures Act. Specifically, the pricing methodology for DME items described in section 1861(n) of the Social Security Act will be equal to the lower of the DMEPOS non-rural Medicare rate or the competitive bidding area rate specific to Alabama.
Approval Date: June 13, 2018
Effective Date: May 1, 2018
Topics: Financing & Reimbursement