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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 8101 - 8110 of 15862

Ohio
This amendment proposes to update the state plan to include utilization from participating MCOs for supplemental drug rebates.
Approval Date: October 13, 2017
Effective Date: January 1, 2018
Topics: Prescription Drugs Program Administration

Iowa
This amendment, limits the payment of Medicare Part A and B deductibles and cost-sharing on Medicare crossover claims for Medicaid state plan services to no more than the Medicaid State plan rate, paying no more than lesser of the amount of the difference between the state plan rate and the Medicare paid amounts, or the deductibles and cost sharing on the claim.
Approval Date: October 13, 2017
Effective Date: July 1, 2017

Louisiana
This state plan amendment proposes to amend the provisions governing hospital services and to establish provisions governing Medicaid reimbursement for legislatively mandated newborn screenings in an acute inpatient hospital setting.
Approval Date: October 13, 2017
Effective Date: August 5, 2017

Wyoming
This Recovery Audit Contractor( RAC) SPA waives certain requirements of Section 1902(a)(42) of the Social Security Act.
Approval Date: October 13, 2017
Effective Date: July 1, 2017

Maine
Adds Opioid Health Home services as authorized under Section 2703 of the Patient Protection and Affordable Care Act.
Approval Date: October 13, 2017
Effective Date: October 1, 2017
Topics: Health Homes Prescription Drugs

Wyoming
This SPA will apply the following income standard\u2014 Unearned income not to exceed 300% of the SSI Payment level.
Approval Date: October 11, 2017
Effective Date: July 1, 2017

California
This amendment makes minor technical revisions to correct item numbering and to update terminology in the personal care services section of the state plan.
Approval Date: October 11, 2017
Effective Date: July 1, 2017

Texas
The state plan amendment updates the fee schedule for physicians and other practitioners.
Approval Date: October 11, 2017
Effective Date: July 1, 2017

California
This State plan amendment (SPA) adds a process for determining if and when the Neonatal Intensive Care Unit (NICU) policy adjustor will apply to hospitals reimbursed under the Diagnosis Related Group (DRG) methodology when Califomia Children's Services (CCS) deterrnines the DRG hospital qualifies as Regional NICU or Community NICU.
Approval Date: October 11, 2017
Effective Date: August 15, 2017

Washington
This amendment implemented three new behavior analysis professions and Applied Behavior Analysis (ABA) credentialing in Washington State.
Approval Date: October 11, 2017
Effective Date: July 1, 2017