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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 10371 - 10380 of 15783

Delaware
This SPA implements a new drug pricing methodology to reimburse pharmacies using National Average Drug Acquisition Cost files for pharmacies that dispense pharmaceutical products to Medicaid recipients.
Approval Date: January 5, 2015
Effective Date: April 1, 2014
Topics: Benefits Financing & Reimbursement Prescription Drugs

Pennsylvania
This SPA describes the methodology used by the state for determining the appropriate FMAP rates, including the increased FMAP rates, available under the provisions of the Affordable Care Act applicable for the medical assistance expenditures under the Medicaid program associated with enrollees in the new adult group adopted by the state.
Approval Date: December 31, 2014
Effective Date: January 1, 2015
Topics: Financing & Reimbursement Program Administration

Delaware
To support individuals with disabilities in attaining and sustaining competitive employment.
Approval Date: December 31, 2014
Effective Date: January 1, 2015
Topics: Benefits Program Administration

New York
Amends the Ambulatory Patient Group methodology for outpatient services, hospital based clinics ambulatory surgery services and emergency room services.
Approval Date: December 31, 2014
Effective Date: July 1, 2010
Topics: Program Administration

Missouri
Incorporates the MAGI-based eligibility process requirements, including the single streamlined application, into Missouri's Medicaid state plan in accordance with the Affordable Care Act.
Approval Date: December 29, 2014
Effective Date: October 1, 2013

Puerto Rico
Establishment of Puerto Rico poverty level (PRPL) for non-ABO (aged, blind, and disabled) coverage groups, expansion of income threshold to 133% of PRPL for R(2) groups.
Approval Date: December 24, 2014
Effective Date: December 31, 2013
Topics: Financing & Reimbursement

Virgin Islands
This SPA incorporates the establishment of the Virgin Islands Poverty Level and 1902(r)(2) disregards to match.
Approval Date: December 24, 2014
Effective Date: December 31, 2013

Puerto Rico
This SPA incorporates MAGI-Based Eligibility Groups and AFDC Income Standards into Puerto Rico's state plan in accordance with the Affordable Care Act.
Approval Date: December 24, 2014
Effective Date: January 1, 2014

Virgin Islands
This SPA incorporates MAGI-Based Eligibility Groups - and AFDC Income Standards into the United States Virgin Islands' state plan in accordance with the Affordable Care Act.
Approval Date: December 24, 2014
Effective Date: January 1, 2014

Pennsylvania
Describes the new Medicaid eligibility group for individuals age 19 through 64, with MAGI-based household income at or below 133 percent of the federal poverty level.
Approval Date: December 23, 2014
Effective Date: January 1, 2015