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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 8521 - 8530 of 15875

Kentucky
The purpose of this SPA is to revise our outpatient pharmacy program to comply with the new reimbursement requirements in CMS'Covered Outpatient Drug final rule with comment CMS 2345-FC.
Approval Date: May 5, 2017
Effective Date: April 1, 2017

New York
Temporary rate adjustment for one additional hospital.
Approval Date: May 5, 2017
Effective Date: January 1, 2017

Ohio
Payment for Services: Outpatient Hospital Payment Schedule Updates.
Approval Date: May 5, 2017
Effective Date: January 1, 2017

Washington
This SPA amends the limitations on prescription drug coverage to clarify that agents when used for cosmetic purposes or hair growth will only be covered when the state has determined that use to be medically necessary.
Approval Date: May 4, 2017
Effective Date: January 1, 2017
Topics: Prescription Drugs Program Administration

West Virginia
Health Homes Pre-Diabetes, Diabetes, Obesity, at Risk for Anxiety and/or Depression.
Approval Date: May 4, 2017
Effective Date: April 1, 2017
Topics: Benefits Eligibility Program Administration

West Virginia
This SPA implements Health Homes.
Approval Date: May 4, 2017
Effective Date: April 1, 2017
Topics: Benefits Eligibility Program Administration

Alaska
This SPA updates reimbursement for Mental Health Clinic Services and Mental Health Rehabilitation Services to reflect a 3% increase.
Approval Date: May 4, 2017
Effective Date: July 1, 2017

Washington
This SPA clarified language regarding state and federal background checks, added some provider types, expanded the scope of certain training, and clarified information regarding assistive technology.
Approval Date: May 3, 2017
Effective Date: January 1, 2017

Connecticut
This SPA provides for APM payments for dates of service from July 1, 2016 to June 30, 2017 to be equal to a clinic's standard medical Prospective Payment System (PPS) encounter rate plus an additional add-on payment per e-consult. Qualified FQHCs will bill e-consults separately from encounters using a modifier to track claim activity.
Approval Date: May 3, 2017
Effective Date: September 30, 2016

Connecticut
Under this SPA, outpatient hospital services are reimbursed using an ambulatory payment classification (APC) system based on Medicare's system but modified for Connecticut's Medicaid program.
Approval Date: May 3, 2017
Effective Date: July 1, 2016