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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 7851 - 7860 of 15783

New York
This amendment proposes to allow the New York State Department of Health to move to actual acquisition cost (AAC) using the National Average Drug Acquisition Cost (NADAC) as the primary basis for its lower of reimbursement methodology for prescription drugs submitted for payment to the medical assistance program, along with a professional dispensing fee (PDF) of $10.00.
Approval Date: December 7, 2017
Effective Date: April 4, 2017

Virginia
This SPA provides for private duty nursing, assistive technology, and personal assistance services under EPSDT.
Approval Date: December 7, 2017
Effective Date: July 1, 2017

California
To remove Amador, Kern, Mendocino, Sacramento and San Joaquin counties from the list of geographic areas offering Targeted Case Management (TCM) services for the "Individuals with a Communicable Disease" TCM group.
Approval Date: December 7, 2017
Effective Date: July 1, 2017
Topics: Program Administration

California
To remove Amador, Marin, Mendocino, Nevada and Sacramento counties from the list of geographic areas offering Targeted Case Management (TCM) services for the "Individuals in Jeopardy of Negative Health or Psycho-Social Outcomes" TCM group.
Approval Date: December 7, 2017
Effective Date: July 1, 2017
Topics: Program Administration

California
To remove Kern and Mendocino counties from the list of geographic areas offering Targeted Case Management (TCM) services for the "Individuals at Risk of Institutionalization" TCM group.
Approval Date: December 7, 2017
Effective Date: July 1, 2017
Topics: Program Administration

California
To remove Amador, Kern and Mendocino counties from the list of geographic areas offering Targeted Case Management (TCM) services for the "Medically Fragile Individuals" TCM group.
Approval Date: December 7, 2017
Effective Date: July 1, 2017
Topics: Program Administration

California
To remove Amador, Kern, Mendocino and Sacramento counties from the list of geographic areas offering Targeted Case Management (TCM) services for the "Children Under The Age of 21" TCM group.
Approval Date: December 7, 2017
Effective Date: July 1, 2017
Topics: Benefits Program Administration

Massachusetts
This amendment revises references to the October l, 2016 effective date for nursing facility reimbursement described in Massachusetts regulations (l0l CMR 206.06).
Approval Date: December 7, 2017
Effective Date: July 1, 2017
Topics: Financing & Reimbursement

Washington
This amendment clarified and simplified the rules for when the Indian Health Service (IHS) encounter rate is paid to IHS and triba facilities.
Approval Date: December 6, 2017
Effective Date: September 29, 2017

Louisiana
This state plan amendment proposes to amend the provisions governing laboratory and radiology services to terminate coverage and reimbursement for proton beam radiation therapy rendered to recipients 21 years of age and older.
Approval Date: December 6, 2017
Effective Date: February 20, 2018
Topics: Benefits Financing & Reimbursement Program Administration