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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 7321 - 7330 of 15869

Montana
This updates the bundled psychiatric service rate for Psychiatric Residential Treatment Facilities (PRFTs) services.
Approval Date: August 21, 2018
Effective Date: July 10, 2018

Idaho
This explains changes the inpatient hospital upper payment limit (UPL) demonstration method from diagnosis related group (DRG) based to cost-based for non-state government owned (NSGO) and private hospitals.
Approval Date: August 21, 2018
Effective Date: June 6, 2018

Maine
This revises reimbursement for inpatient hospital services. Specifically it: 1) adds reimbursement for Long Active Reversible Contraceptives (LARC) during postpartum inpatient hospital stay to provide adequate reimbursement to provider for the device; 2) changes data used to calculate Prospective Interim Payment (PIP) to provide more accuracy; and 3) further revises the state's fourteen day readmission protocol which was approved under TN 14-0003 and further amended under TN 15- 0010.
Approval Date: August 21, 2018
Effective Date: November 14, 2017

Michigan

This SPA allows for nursing facility quality incentive initiative. A quality measure initiative (QMI) payment is established for class i and class iii nursing facilities.

Approval Date: August 20, 2018
Effective Date: October 1, 2017

Washington
This SPA corrects an error associated with the approval of WA SPA 18-0003.
Approval Date: August 20, 2018
Effective Date: January 1, 2018

Oklahoma
This implement a 3% rate increase for Level 1 Licensed Behavioral Health Practitioners in independent practice.
Approval Date: August 20, 2018
Effective Date: July 1, 2018

Montana
This removes the fee schedule for Service 19c. Targeted Case Management (TCM) Services for Individuals with Developmental Disabilities (DD) Age 16 and Over or Who Reside in a DD Children's Group Home State Plan from MT's 4.19 B Intro Page for non-Institutional services. The date of the removal from the Intro page will be June 1, 2018.
Approval Date: August 20, 2018
Effective Date: June 1, 2018

Florida
This increases the Personal Needs Allowance for Medicaid residents in institutional settings.
Approval Date: August 17, 2018
Effective Date: July 1, 2018

North Carolina
This is to clarify definitions and procedures in the Estate Recovery Program.
Approval Date: August 17, 2018
Effective Date: October 1, 2018

Connecticut
This SPA amends Attachment 4.19-B of the Medicaid State Plan to update the reimbursement methodology for attendant care services provided in the Community First Choice Program pursuant to section 1915(k) of the Social Security Act to conform to the permissible hourly wages for attendants set forth in the applicable collective bargaining agreement. If no collective bargaining agreement is in effect at the time a service is provided, the permissible hourly wages will be in accordance with the most recent collective bargaining agreement.
Approval Date: August 16, 2018
Effective Date: April 1, 2018