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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 7281 - 7290 of 15830

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

New York
An increase in the Fee-For-Service nursing home per diem rate by 17% for select nursing homes.
Approval Date: August 21, 2018
Effective Date: June 22, 2018
Topics: Financing & Reimbursement

Montana
This updates the bundled psychiatric service rate for Psychiatric Residential Treatment Facilities (PRFTs) services.
Approval Date: August 21, 2018
Effective Date: July 10, 2018
Topics: Financing & Reimbursement

Idaho
This explains changes the inpatient hospital upper payment limit (UPL) demonstration method from diagnosis related group (DRG) based to cost-based for non-state government owned (NSGO) and private hospitals.
Approval Date: August 21, 2018
Effective Date: June 6, 2018
Topics: Financing & Reimbursement

Michigan

This SPA allows for nursing facility quality incentive initiative. A quality measure initiative (QMI) payment is established for class i and class iii nursing facilities.

Approval Date: August 20, 2018
Effective Date: October 1, 2017
Topics: Health Services Initiatives

Oklahoma
This implement a 3% rate increase for Level 1 Licensed Behavioral Health Practitioners in independent practice.
Approval Date: August 20, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement

Washington
This SPA corrects an error associated with the approval of WA SPA 18-0003.
Approval Date: August 20, 2018
Effective Date: January 1, 2018
Topics: Program Administration

Montana
This removes the fee schedule for Service 19c. Targeted Case Management (TCM) Services for Individuals with Developmental Disabilities (DD) Age 16 and Over or Who Reside in a DD Children's Group Home State Plan from MT's 4.19 B Intro Page for non-Institutional services. The date of the removal from the Intro page will be June 1, 2018.
Approval Date: August 20, 2018
Effective Date: June 1, 2018
Topics: Financing & Reimbursement

Florida
This increases the Personal Needs Allowance for Medicaid residents in institutional settings.
Approval Date: August 17, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement

North Carolina
This is to clarify definitions and procedures in the Estate Recovery Program.
Approval Date: August 17, 2018
Effective Date: October 1, 2018
Topics: Program Administration