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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 7271 - 7280 of 15830

Montana
This clarifies MT's transportation service reimbursement, and adds Transportation to MT' s Introduction ( or Frontice) Page for non-institutional services 4.19B reimbursement.
Approval Date: August 23, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement

Montana
A revision for the service number where Montana has Free Standing Birthing Centers displayed in the State Plan and adds the service's reimbursement effective date to Montana's 4.19B Introduction Page.
Approval Date: August 23, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement

South Dakota
This increases and also clarifies the reimbursement methodology for out of state specialty hospitals.
Approval Date: August 23, 2018
Effective Date: April 1, 2018

Georgia
This allows the Commissioner to waive the first $25,000 of an estate in order to prevent substantial and unreasonable hardship.
Approval Date: August 23, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement

Ohio
This amendment proposes to stop implementation of OH SPA TN 17-041.
Approval Date: August 23, 2018
Effective Date: June 19, 2018
Topics: Program Administration

Massachusetts
This proposes comprehensive changes to rate year (RY) 2018 reimbursement methodology lor three (3) distinct type of private inpatient chronic disease and rehabilitation (CDR) hospital services (specified, pediatric, and all other non-pediatric) resulting in a total increase of $19.2M.
Approval Date: August 23, 2018
Effective Date: October 1, 2017
Topics: Financing & Reimbursement

Montana
This updates the fee schedule effective date for MT's EPSDT services under non-institutional services 4. l 9B reimbursement.
Approval Date: August 23, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement

Indiana
This SPA adds reimbursement for the services provided by a community mental health center on or after August 1, 2017 that are enrolled qualified clinics approved by the state, and shall be reimbursed by the Medicaid RBRVs fee schedule, or percentage thereof, of the practitioner employed or contracted with the clinic.
Approval Date: August 22, 2018
Effective Date: August 1, 2017
Topics: Financing & Reimbursement

Maine
This revises reimbursement for inpatient hospital services. Specifically it: 1) adds reimbursement for Long Active Reversible Contraceptives (LARC) during postpartum inpatient hospital stay to provide adequate reimbursement to provider for the device; 2) changes data used to calculate Prospective Interim Payment (PIP) to provide more accuracy; and 3) further revises the state's fourteen day readmission protocol which was approved under TN 14-0003 and further amended under TN 15- 0010.
Approval Date: August 21, 2018
Effective Date: November 14, 2017
Topics: Financing & Reimbursement

Utah
This SPA updates the inflation and utilization trend for the required outpatient hospital upper payment limit (UPL) demonstration as well as updates the language for the private hospital supplemental payments.
Approval Date: August 21, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement