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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 7331 - 7340 of 15829

New York
This amendment reallocates certain Disproportionate Share Hospital (DSH) payments that would exceed the hospital-specific DSH limit, defines two distinct DSH state plan rate years (SPRY), clarifies some existing DSH provisions and eliminates other obsolete DSH provisions.
Approval Date: July 26, 2018
Effective Date: January 1, 2011
Topics: Financing & Reimbursement

Texas
This amendment updates the physicians and other practitioners' schedules.
Approval Date: July 26, 2018
Effective Date: June 1, 2018
Topics: Program Administration

New York
This amendment continues to provide for supplemental payments to certain non-state government nursing homes.
Approval Date: July 26, 2018
Effective Date: April 1, 2018
Topics: Financing & Reimbursement

Utah
This State Plan Amendment increases the monthly nursing visit limit for hemophilia patients and requires prior authorization for additional visits. It also clarifies reimbursement methodology for covered outpatient drugs, removes NADAC as a component of the UMAC.
Approval Date: July 26, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement Program Administration

New York
This amendment provides temporary Vital Access Provider / Safety Net Provider (VAP/SNP) enhanced payments to Elderwood at Northcreek Nursing Facility.
Approval Date: July 26, 2018
Effective Date: April 1, 2018
Topics: Financing & Reimbursement

Michigan
This SPA assists with the improved access to home health care and durable medical equipment under home health services.
Approval Date: July 26, 2018
Effective Date: July 1, 2018

Connecticut
This SPA amends Attachment 4.19-B to incorporate various 2016 Healthcare Common Procedure Coding System (HCPCS) changes (additions, deletions and description changes) to the physician fee schedule.
Approval Date: July 25, 2018
Effective Date: January 1, 2016
Topics: Program Administration

New York
This amendment will provide temporary quarterly supplemental payments to Strong Memorial Hospital.
Approval Date: July 25, 2018
Effective Date: April 1, 2018
Topics: Financing & Reimbursement

Arkansas
This amendment proposes to delete Hysterectomy, Appendectomy, Uncomplicated Pediatric Pneumonia and Urinary Tract Infection Episodes of Care.
Approval Date: July 25, 2018
Effective Date: July 1, 2018

Washington
This amendment identified the threshold dollar amount the Health Care Authority (HCA) uses to pursue recovery of medical services claims that were paid by Medicaid when a commercial insurance had primary responsibility for payment.
Approval Date: July 25, 2018
Effective Date: July 1, 2018
Topics: Program Administration