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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 7351 - 7360 of 15828

Illinois
Implements health and Homes as authorized under Section 2703 of the Patient Protection and Affordable Care Act.
Approval Date: July 18, 2018
Effective Date: October 1, 2018

New York
This amendment proposes to continue a pay for performance quality incentive payment program for non-specialty nursing facilities and a related proportional rate reduction.
Approval Date: July 18, 2018
Effective Date: July 18, 2018
Topics: Program Administration

New York
This State Plan Amendment implements changes to the delivery and reimbursement of health care services via telehealth.
Approval Date: July 18, 2018
Effective Date: April 1, 2018
Topics: Financing & Reimbursement

Wyoming
Change the payment methodology for DME/POS based on the 21st Century CURES ACT, to pay 100% of the lowest Medicare rate for those codes impacted by the CURES ACT, except oxygen and oxygen services.
Approval Date: July 18, 2018
Effective Date: June 1, 2018
Topics: Financing & Reimbursement

Nebraska
This modifies coverage and reimbursement for Psychiatric Residential Treatment Facility (PRTF) leave days. Leave days will be reimbursed at 50 percent of the PRTF per diem rate for a maximum of 5 days per treatment episode for medical leave and l0 days per treatment episode for therapeutic leave.
Approval Date: July 17, 2018
Effective Date: May 1, 2018
Topics: Benefits Financing & Reimbursement

Wyoming
Exempts the State from the requirement for a full-time medical director, with an increased look back period and an increased contingency fee percentage to facilitate the State's attempt to procure an RAC contractor.
Approval Date: July 17, 2018
Effective Date: July 1, 2018
Topics: Program Administration

Louisiana
This proposes to amend the provisions governing managed care for physical and behavioral health to clarify that Medicaid recipients who are in need of applied behavior analysis-based therapy must access these services through a managed care organization under the Health Louisiana program.
Approval Date: July 13, 2018
Effective Date: July 20, 2018
Topics: Program Administration

North Carolina
This state plan amendment is submitted in order to allow all years of pre-graduate and post-graduate full-time Mental Health, Developmental Disability, and Substance Abuse Services (MH/DD/SAS) experience to apply to the qualifications required for MH/DD/SAS Qualified Professionals.
Approval Date: July 13, 2018
Effective Date: April 1, 2018
Topics: Program Administration

New Hampshire
This transmits language to amend the NH Title State Plan to include a 1915(i) section in order to provide home and community-based services to children with serious behavioral health issues through a coordinated model.
Approval Date: July 12, 2018
Effective Date: July 1, 2018

Oklahoma
This amendments updates the State's Early and Periodic Screening, Diagnostic and Treatment (EPSDT) periodicity schedule.
Approval Date: July 12, 2018
Effective Date: September 1, 2018