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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 13091 - 13100 of 15720

New York
This amendment denies additional Medicaid payments for costs incurred for potentially preventable conditions in the inpatient hospital setting.
Approval Date: May 25, 2012
Effective Date: July 1, 2011

Ohio
Disproportionate Share Hospital (DSH) Program: Redistribution post DSH audit.
Approval Date: May 25, 2012
Effective Date: October 1, 2011

New York
This amendment will also carve out medication costs from the inpatient PR TF rates.
Approval Date: May 25, 2012
Effective Date: July 1, 2011

Michigan
Implements Requirements for Non-Payments for Provider-Preventable Conditions.
Approval Date: May 25, 2012
Effective Date: January 1, 2011

Illinois
Pharmacy services - Wholesale acquisition cost reimbursement methodology.
Approval Date: May 25, 2012
Effective Date: February 1, 2012

Iowa
This amendment eliminates graduate medical education (GME) payments to out-of-State hospitals, reduces GME payments to in-State hospitals, and imposes payment reductions for health care-acquired conditions per section 2702 of the Affordable Care Act.
Approval Date: May 25, 2012
Effective Date: September 1, 2011

Wisconsin
This amendment revises payment methodologies for inpatient hospital services. Specifically, this amendment eliminates the length of stay outlier payment; clarifies that Medicare cost report data is obtained through the Health Cost Reporting Information System (HCRIS) maintained by the Center for Medicare and Medicaid Services (CMS); increases the standard DRG group rate; increases the "trimpoint" amount for hospitals to qualify for a cost outlier payment; proposes supplemental disproportionate share hospital (DSH) payments for State, County and Private hospitals; creates a second level of supplemental payments to essential access city hospitals; increases the amount of inpatient access payments to acute care, children's, rehabilitation, and critical access hospitals.
Approval Date: May 25, 2012
Effective Date: July 1, 2011
Topics: Financing & Reimbursement

Michigan
This amendment brings the State into compliance with Federal requirements with respect to non-payment for provider-preventable conditions.
Approval Date: May 25, 2012
Effective Date: July 1, 2011
Topics: Program Administration

Idaho
his SPA reduces the amount, duration and scope of dental services available to individuals over the age of twenty-one, limiting the dental benefit package to emergency and medically necessary oral surgery and palliative services and associated diagnostic services. The benefit changes apply to non-pregnant adults over the age of twenty-one (21), who are eligible for Medicaid's Basic or Enhanced plans.
Approval Date: May 25, 2012
Effective Date: July 1, 2011

Oklahoma
The plan amendment sunsets provider type Certified Alcohol and Drug Counselor from qualified providers for certain outpatient psychotherapy over a period of two years.
Approval Date: May 24, 2012
Effective Date: July 1, 2012