U.S. flag

An official website of the United States government

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 10111 - 10120 of 15783

Virginia
Adopts a price-based prospective payment system for Virginia nursing facility services that will transition from RUG-III 34 Medicaid grouper to the RUG-IV 48 grouper.
Approval Date: May 4, 2015
Effective Date: April 1, 2015
Topics: Financing & Reimbursement

Tennessee
Revises payment methodology for intermediate care facilities/individuals sith intellectual disabilities services.
Approval Date: May 4, 2015
Effective Date: July 1, 2014
Topics: Financing & Reimbursement Program Administration

Mississippi
Incorporates the Modified Adjusted Gross Income (MAGI) based eligibility process requirements, including the single streamlined application into the Medicaid state plan in accordance with the Affordable Care Act.
Approval Date: May 1, 2015
Effective Date: January 1, 2015

Nebraska
Disregards an amount equal to premiums paid for private/commercially available health insurance when determining the eligibility of persons in the Qualified Medicare Beneficiaries, Specified Low-income Medicare Beneficiaries, Qualifying Individuals, Working Disabled, or Aged and Disabled eligibility groups.
Approval Date: May 1, 2015
Effective Date: January 1, 2015
Topics: Financing & Reimbursement Program Administration

Oklahoma
Removing financial criteria that is more restrictive than those of the SSI Program.
Approval Date: May 1, 2015
Effective Date: January 1, 2015
Topics: Financing & Reimbursement Program Administration

Oklahoma
Changes in family planning services.
Approval Date: April 30, 2015
Effective Date: July 1, 2015

Maine
This SPA updates and amends pharmacy coverage and reimbursement sections of the state plan.
Approval Date: April 30, 2015
Effective Date: April 1, 2012
Topics: Financing & Reimbursement Prescription Drugs

California
To incorporate MAGI-based eligibility groups into California's Medicaid State Plan.
Approval Date: April 29, 2015
Effective Date: January 1, 2014
Topics: Eligibility Program Administration

Washington
This SPA clarified the policy for Rural Health Clinics (RHC's) to request a rate adjustment for a change of scope of services.
Approval Date: April 28, 2015
Effective Date: March 12, 2015
Topics: Financing & Reimbursement Program Administration

Washington
This SPA clarified the policy for Federal Qualified Health Centers (FQHC's) to request a rate adjustment for a change of scope of services.
Approval Date: April 28, 2015
Effective Date: March 12, 2015
Topics: Financing & Reimbursement Program Administration