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.

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North Carolina

Reduces payment rates that were in effect as of June 30, 2013 by 10 percent for state fiscal years 2014 and 2014.

Approval Date: June 19, 2014

Effective Date: January 1, 2014

Links:

Approval Document

Topics: Financing & Reimbursement

Arkansas

Increases the Medicaid maximum reimbursement rate for the Mirena IUD and adding Medicaid coverage to include the Skyla IUD to long term family planning services under the Arkansas State Plan.

Approval Date: June 19, 2014

Effective Date: October 1, 2014

Links:

Approval Document

Topics: Benefits Financing & Reimbursement Prescription Drugs Program Administration

New Hampshire

This SPA describes the methodology used by thr state for determining the appropriate FMAP rates, including the increased FMAP rates available under the provisions of the Affordable Care Act applicable for the medical assistance expenditures under the Medicaid program associated with enrollees in the new adult group adopted by the state.

Approval Date: June 19, 2014

Effective Date: July 1, 2014

Links:

Approval Document

Topics: Financing & Reimbursement Program Administration

Connecticut

Establishes Single State Agency and Entities Responsible for Determinations of Eligibility and Appeals/Fair Hearings.

Approval Date: June 18, 2014

Effective Date: January 1, 2014

Links:

Approval Document

Topics: Eligibility

Massachusetts

To incorporate the methodology used by the Commonwealth to determine the appropriate FMAP rates, including the increased FMAP rates, available under the provisions of the Affordable Care Act applicable to the medical assistance expenditures for enrollees in the new adult eligibility group adopted by the Commonwelth and described in 42 CFR 435.119.

Approval Date: June 18, 2014

Effective Date: January 1, 2014

Links:

Approval Document

Topics: Financing & Reimbursement Program Administration

Connecticut

Establishes a rate of payment for home health medication administration services delegated by registered nurses and provided by home health aides with certification to administer medications.

Approval Date: June 18, 2014

Effective Date: March 15, 2014

Links:

Approval Document

Topics: Financing & Reimbursement Prescription Drugs Program Administration

US Virgin Islands

This SPA proposes to change the service limits for comprehensive tobacco cessation services provided to pregnant women, including both counseling and pharmacotherapy, without cost sharing.

Approval Date: June 18, 2014

Effective Date: October 1, 2013

Links:

Approval Document

Topics: Benefits

Kentucky

Provides Targeted Case Management (TCM) Services for Three New Targeted Populations Requiring Mental Health Services.

Approval Date: June 18, 2014

Effective Date: July 1, 2014

Links:

Approval Document

Topics: Program Administration

Wyoming

This amendment proposes to remove the drug categories of barbiturates, benzodiazepines and smoking cessation drugs from the list of drugs that may be excluded or otherwise restricted from coverage from the state plan effective January 1, 2014 in accordance with the provisions of section 2502 of the Affordable Care Act which amends section 1927(d)(2) of the Social Security Act by removing barbiturates, benzodiazepines and agents used to promote smoking cessation from the list of drugs a state Medicaid program may exclude from coverage or otherwise restrict.

Approval Date: June 18, 2014

Effective Date: August 1, 2014

Links:

Approval Document

Topics: Prescription Drugs

Florida

This amendment allows the current Medical School physician supplement payment methodology to continue for services through June 30, 2014 with a maximum total computable reimbursement of $83,384,893.

Approval Date: June 18, 2014

Effective Date: January 1, 2014

Links:

Approval Document

Topics: Financing & Reimbursement

Medicaid State Plan Amendments

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Transmittal Number: NC-14-002

Transmittal Number: AR-14-06 I

Transmittal Number: NH-14-007

Transmittal Number: CT-14-0004-MM4

Transmittal Number: MA-14-004

Transmittal Number: CT-14-011

Transmittal Number: VI-13-006

Transmittal Number: KY-14-002-

Transmittal Number: WY-14-009

Transmittal Number: FL-14-007