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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 12161 - 12170 of 15760

Maine
Makes changes to the reimbursement method for inpatient hospital services.
Approval Date: July 18, 2013
Effective Date: April 24, 2012
Topics: Financing & Reimbursement

Georgia
Eliminate the 30 day time frame in which a nursing facility is required to submit a request for a Fair Rental Value Rate increase.
Approval Date: July 18, 2013
Effective Date: July 1, 2013
Topics: Financing & Reimbursement

Nebraska
Methodology for Reimbursement of Practitioner Administered Injectable Medications.
Approval Date: July 17, 2013
Effective Date: April 1, 2013

Wyoming

Free Standing Birthing Centers.

Approval Date: July 16, 2013
Effective Date: July 1, 2013
Topics: Health Services Initiatives Program Administration

Vermont
Updates provider types authorized to deliver services via telemedicine.
Approval Date: July 16, 2013
Effective Date: October 1, 2012
Topics: Prescription Drugs Program Administration

New York

Provider Screening and Enrollment.

Approval Date: July 16, 2013
Effective Date: April 1, 2013
Topics: Health Services Initiatives Program Administration

New York
Continues the Hospital-Based Outpatient Ambulatory Patient Group (APG) payment methodology.
Approval Date: July 16, 2013
Effective Date: April 1, 2013
Topics: Financing & Reimbursement Program Administration

Louisiana
This state plan amendment revises the implementation date of the Recovery Audit Contract (RAC) program to comply with the federal requirements under Section 6411 of the Affordable Care Act. The State will have a Medicaid RAC program in place no later than June 30, 2013.
Approval Date: July 16, 2013
Effective Date: June 30, 2013

Utah
This amendment clarifies that Medicaid, as payor of last resort, utilizes third party payment methodology for crossover claims of Medicaid beneficiaries.
Approval Date: July 16, 2013
Effective Date: July 1, 2013
Topics: Financing & Reimbursement

Utah
This SPA deals with Preadmission Screening by Catergorical Determination PASRR implementing a new template and allowing the State to add the Short Stay Categorical Determination as a new category type.
Approval Date: July 16, 2013
Effective Date: May 1, 2013
Topics: Program Administration