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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 6461 - 6470 of 15867

Oklahoma
Delineates out-of-state providers and participation requirements and amends reimbursement methodology for providers physically outside of OK.
Approval Date: September 9, 2019
Effective Date: September 1, 2019
Topics: Financing & Reimbursement Program Administration

New Hampshire
"Utilization/ Quality Control - In House" which transmitted language to amend the NH Title XIX State plan to shift quality improvement work previously carried out by a vendor to NH departmental staff.
Approval Date: September 9, 2019
Effective Date: July 1, 2019

California
The Quality Assurance Fee (QAF) program and reimbursement add-on for Ground Emergency Medical Transports (GEMT) provided by emergency medical transportation providers to Medi-Cal patients.
Approval Date: September 6, 2019
Effective Date: July 1, 2019

Maine
Change chiropractic services resulting from Maine Public Law 2017, chapter 421.
Approval Date: September 6, 2019
Effective Date: April 12, 2019
Topics: Benefits Program Administration

Maryland
1915i waiver renewal amends the services and eligibility requirements to expand access to necessary behavioral health services.
Approval Date: September 5, 2019
Effective Date: October 1, 2019
Topics: Benefits Program Administration

North Dakota
Implement an increase to the professional fee schedule for vaccines under the Pediatric Immunization program.
Approval Date: September 4, 2019
Effective Date: July 1, 2019

Montana
Change the maximum dispensing fee for each tier, to accurately reflect the provider rate increase appropriated by the Montana Legislature.
Approval Date: September 4, 2019
Effective Date: July 1, 2019
Topics: Financing & Reimbursement Program Administration

New York
Authorizes the diabetes prevention services as outlined by the Centers for Disease Control and Prevention recognized National Diabetes Prevention Program.
Approval Date: September 4, 2019
Effective Date: July 1, 2019
Topics: Benefits Program Administration

South Dakota
Establishes supplemental payments for in-state private hospitals.
Approval Date: September 3, 2019
Effective Date: January 1, 2019
Topics: Cost Sharing Financing & Reimbursement

Louisiana
Proposes to repeal the provisions governing radiation utilization management services in order to align with the current fee-for-service and managed care practices relative to prior authorization of high-end radiology services.
Approval Date: August 30, 2019
Effective Date: September 20, 2019