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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 8491 - 8500 of 15833

Connecticut
Increases payment rates for private behavioral health clinics.
Approval Date: May 3, 2017
Effective Date: July 1, 2015
Topics: Financing & Reimbursement

Connecticut
Updates the Physician Radiology Fee Schedule by removing Current Procedural Terminology (CPT) codes: 77061 (Digital breast tomosynthesis; unilateral), 77062 (Digital breast tomosynthesis; bilateral) and 77063 (Screening digital breast tomosynthesis, bilateral).
Approval Date: May 3, 2017
Effective Date: February 4, 2015
Topics: Financing & Reimbursement Program Administration

Delaware
Expands coverage and allow reimbursement for chiropractors' services for all Medicaid eligible individuals.
Approval Date: May 3, 2017
Effective Date: January 1, 2017

Vermont
Recovery Audit Contractor Exception.
Approval Date: May 2, 2017
Effective Date: January 1, 2017

New York
Extends the Ambulatory Patient Group (APG) methodology for freestanding clinics and ambulatory surgery center services from January 1, 2016 through December 31, 2017.
Approval Date: May 2, 2017
Effective Date: January 1, 2016

Wisconsin
Revises the reimbursement methodology for inpatient hospital rates and methodologies for measurement year 2016 pay for performance program updates.
Approval Date: May 2, 2017
Effective Date: July 1, 2015
Topics: Financing & Reimbursement

Texas
This state plan amendment updates the family planning fee schedule.
Approval Date: May 1, 2017
Effective Date: January 1, 2017
Topics: Financing & Reimbursement

Texas
This state plan amendment updates the durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) fee schedule.
Approval Date: May 1, 2017
Effective Date: January 1, 2017
Topics: Financing & Reimbursement

Texas
This state plan amendment updates the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program fee schedule.
Approval Date: May 1, 2017
Effective Date: January 1, 2017
Topics: Financing & Reimbursement

Texas
This state plan amendment updates the clinical diagnostic laboratories (CDL) fee schedule.
Approval Date: May 1, 2017
Effective Date: January 1, 2017
Topics: Financing & Reimbursement