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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 7771 - 7780 of 15783

Iowa
This SPA adjusted the reimbursement policy eliminating the primary care physician rate increase originally authorized by the Federal Health Care & Education Reconciliation Act of 2010.
Approval Date: January 10, 2018
Effective Date: July 1, 2017
Topics: Financing & Reimbursement

Louisiana
Amends the provisions governing reimbursement for Targeted Case Management services provided to participants in the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program, in order to adopt a payment methodology based on a flat monthly rate rather than 15-minute increments.
Approval Date: January 9, 2018
Effective Date: April 1, 2018
Topics: Financing & Reimbursement

South Carolina
Increases the payment rates for nursing facilities owned and operated by the South Carolina Department of Mental Health based on the 2015 cost reports trended to the rate year 2016.
Approval Date: January 5, 2018
Effective Date: October 1, 2016
Topics: Financing & Reimbursement

Montana
Reimbursement update for Medical Equipment and Supplies.
Approval Date: January 4, 2018
Effective Date: February 1, 2018
Topics: Financing & Reimbursement

Nevada
Updates the reimbursement methodology for pediatric services.
Approval Date: January 2, 2018
Effective Date: October 14, 2017
Topics: Financing & Reimbursement

Indiana
This state plan amendment makes changes to definitions and terminology in compliance with state law, removes the 20-mile restriction between patient and provider, and revises the permissible telemedicine provider and service types.
Approval Date: January 2, 2018
Effective Date: October 1, 2017
Topics: Program Administration

New York
Extends the Ambulatory Patient Group methodology for hospital-based clinic and ambulatory surgery services, including emergency room services, for the period January 1, 2015 through December 31, 2015.
Approval Date: January 1, 2018
Effective Date: January 1, 2015

New York
A This SPA authorizes supplemental payments for certain general hospitals for outpatient services furnished in 2015.
Approval Date: December 28, 2017
Effective Date: April 1, 2015
Topics: Financing & Reimbursement

Delaware
This amendment modifies the Modified Adjusted Gross Income (MAGI)-Based Eligibility Groups to add the Individuals Over 133% FPL and Under Age 65 group related specifically to an 1115 demonstration.
Approval Date: December 28, 2017
Effective Date: January 1, 2018
Topics: Financing & Reimbursement Program Administration

Arizona
This SPA revises ambulance rates.
Approval Date: December 28, 2017
Effective Date: October 1, 2017
Topics: Financing & Reimbursement