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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 10911 - 10920 of 15780

Arkansas
Increases the Medicaid maximum reimbursement rate for the Mirena IUD and adding Medicaid coverage to include the Skyla IUD to long term family planning services under the Arkansas State Plan.
Approval Date: June 19, 2014
Effective Date: October 1, 2014
Topics: Benefits Financing & Reimbursement Prescription Drugs Program Administration

Arkansas
Eliminates the Arkansas Breast Cervical Cancer program.
Approval Date: June 19, 2014
Effective Date: January 1, 2014

New York
This amendment proposes to set the inpatient hospital payment rate for those out-of-state hospitals in larger cities - with a population equal to or greater than 500,000 people - at a rate equal to the weighted average rate for in-state rate hospitals in the Downstate Region.
Approval Date: June 19, 2014
Effective Date: March 13, 2014
Topics: Financing & Reimbursement

New York
This amendment (1) revises the maximum & minimum utilization percentages used in the rate setting methodology and (2) eliminates the 2014 trend factor from the rate calculation.
Approval Date: June 19, 2014
Effective Date: July 1, 2013
Topics: Program Administration

Northern Mariana Islands
This amendment updates the reimbursement methodology for dental and transportation services.
Approval Date: June 19, 2014
Effective Date: April 1, 2014
Topics: Dental Program Administration

Maine
Establishes shared savings arrangements with provider organizations that commit to coordinating patient care.
Approval Date: June 19, 2014
Effective Date: July 1, 2014
Topics: Financing & Reimbursement Program Administration

Texas
Removes the reference in the state plan to requirements related to physician qualifications which were eliminated under Section 4742 (a) of the Balanced Budget Act of 1997.
Approval Date: June 19, 2014
Effective Date: April 1, 2014
Topics: Program Administration

New Mexico
Reorganization and revision of those payment and reimbursement pages which presented companion issues to the State's proposed alternative Benefit Program.
Approval Date: June 19, 2014
Effective Date: January 1, 2014
Topics: Financing & Reimbursement

California
Updates the All Patient Refined Diagnosis Related Group payment parameters.
Approval Date: June 19, 2014
Effective Date: July 1, 2014
Topics: Financing & Reimbursement Program Administration

New Hampshire
This SPA describes the methodology used by thr 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: June 19, 2014
Effective Date: July 1, 2014
Topics: Financing & Reimbursement Program Administration