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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 10681 - 10690 of 15783

Mississippi
This amendment transitions from a manual method of identifying and adjusting claims subject to inpatient hospital Health Care Acquired Conditions to the implementation of the 3M All Patient Refined Grouper (APR-DRG) HCAC utility.
Approval Date: September 12, 2014
Effective Date: July 1, 2014
Topics: Program Administration

Illinois
Changes the dispensing fee for 340B purchased drugs to $12.00 for both single source and multiple source drugs.
Approval Date: September 12, 2014
Effective Date: February 1, 2013
Topics: Financing & Reimbursement Prescription Drugs

North Carolina
This amendment clarifies the reimbursement methodology for Targeted Case Management for Adults and Children At-Risk for Abuse, Neglect or Exploitation (ARCM).
Approval Date: September 12, 2014
Effective Date: March 1, 2011
Topics: Financing & Reimbursement

West Virginia
This SPA modifies the State's methods and standards for reimbursing inpatient hospital services. Specifically, this amendment continues a system of supplemental payments to private and non-State government owned (NSGO) public acute care hospitals.
Approval Date: September 12, 2014
Effective Date: July 1, 2014
Topics: Financing & Reimbursement Program Administration

Utah
This Amendment allows a beneficiary under a long-term care insurance policy to receive a resource disregard equal to insurance benefit payments made to or on behalf of the individual.
Approval Date: September 11, 2014
Effective Date: October 1, 2014
Topics: Financing & Reimbursement

Colorado
This SPA amends adult dental sections of the state plan to impose annual maximum for services, implement Denture (prosthetics) services, implement fee- schedule for adults accessing state plan dental services through the HCBS waivers.
Approval Date: September 11, 2014
Effective Date: July 1, 2014
Topics: Dental Financing & Reimbursement Program Administration

Minnesota
Supplemental Payment for Certain Physician, EPSDT and Other Licensed Practitioner Services.
Approval Date: September 11, 2014
Effective Date: September 1, 2011
Topics: Financing & Reimbursement

Illinois
This amendment proposes to remove barbiturates, benzodiazepines, and agents used to promote smoking cessation from the list of drugs the state Medicaid program may exclude from coverage or otherwise restrict in order to comply with the requirements of Section 2502(a) of the Affordable Care Act.
Approval Date: September 10, 2014
Effective Date: January 1, 2014

South Carolina
The purpose of this new amendment was to align the Reasonably Predictable Changes in income selections on the S10 plan page to what the state entered on their Federally Facilitated Marketplace (FFM) data collection tool.
Approval Date: September 10, 2014
Effective Date: April 1, 2014

Iowa
Implements Dispensing Fee Increase from $10.12 to $11.73 Per Prescription.
Approval Date: September 10, 2014
Effective Date: August 1, 2014