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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 13301 - 13310 of 15726

Ohio
Modification of the UPL gap calculation for outpatient hospital services.
Approval Date: March 8, 2012
Effective Date: July 1, 2011

South Carolina
This SPA proposes to revise the payment methodology for Nursing Facility services. Specifically, this amendment proposes to replace the intensive Technical Services reimbursement program with the Complex care reimbursement program and update the payment rate for this program.
Approval Date: March 8, 2012
Effective Date: October 1, 2011
Topics: Financing & Reimbursement

Pennsylvania
This amendment adds language that allows Pennsylvania to recover overpayments of disproportionate share (DSH) payments that exceed a hospital's specific DSH limit as defined by section 1923(g) of the Social Security Act.
Approval Date: March 6, 2012
Effective Date: October 1, 2011
Topics: Financing & Reimbursement Program Administration

New York
APGs Ancillary Services.
Approval Date: March 6, 2012
Effective Date: September 1, 2009

Nebraska
Which proposes to reduce the fee schedule rates by 2.5% with a proposed effective date of July 1, 2011.
Approval Date: March 6, 2012
Effective Date: July 1, 2011

Nebraska
Which proposes to reduce the fee schedule rates for clinical laboratory services by 2.5% with a proposed effective date of July 1, 2011.
Approval Date: March 6, 2012
Effective Date: July 1, 2011

Nebraska
Which proposes to reduce the fee schedule rates for outpatient hospital and lab services by 2.5% with a proposed effective date of July 1, 2011.
Approval Date: March 6, 2012
Effective Date: July 1, 2012

Wyoming
Modifies the reimbursement methodology necessary to comply with CMS regulations specific for provider preventable conditions.
Approval Date: March 6, 2012
Effective Date: October 1, 2011

Nebraska
Increase in co-payments.
Approval Date: March 6, 2012
Effective Date: October 24, 2011

Nebraska
Proposes to reduce the fee schedule rate for physician services by 2.5% with a proposed effective date of July 1, 2011.
Approval Date: March 6, 2012
Effective Date: July 1, 2012