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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 12281 - 12290 of 15759

Illinois
Provider screening and enrollment assurances.
Approval Date: June 10, 2013
Effective Date: April 1, 2013

Pennsylvania
Proposes the addition of H.P. Acthar Gel to the list of drugs requiring prior authorization for pharmacy services.
Approval Date: June 7, 2013
Effective Date: June 3, 2013

North Carolina
Establishes a new eligibility group for the family planning services.
Approval Date: June 7, 2013
Effective Date: November 1, 2013

Kentucky
Requires that Medicaid pay physicians practicing in family medicine, general internal medicine, pediatric medicine, and related subspecialists at Medicare levels for the procedure codes specified in the Act for Calendar Years 2013 and 2014.
Approval Date: June 7, 2013
Effective Date: January 1, 2013
Topics: Financing & Reimbursement Program Administration

District of Columbia
Medicaid Pediatric Palliative Care. Medicaid Case Management.
Approval Date: June 7, 2013
Effective Date: January 1, 2013
Topics: Program Administration

Oklahoma
This state plan amendment documents the inclusion of children receiving Title IV-E kinship guardianship assistance payments as a covered population under the mandatory Title JV-E eligibility group.
Approval Date: June 6, 2013
Effective Date: January 1, 2013
Topics: Financing & Reimbursement

Georgia
Proposes to Revise the Disproportionate Share Payment (DSH) Allocation Methodology for Hospitals.
Approval Date: June 6, 2013
Effective Date: July 1, 2013
Topics: Financing & Reimbursement

Louisiana
The state plan increases the reimbursement rates for physician services rendered by health plans in the coordinated care networks as well as fee-for-service visits to meet compliance with Section 1202 of the Patient Protection and Affordable Care Act (PPACA) and federal regulations.
Approval Date: June 6, 2013
Effective Date: January 1, 2013
Topics: Financing & Reimbursement

Kentucky
Revises the payment methodology for Psychiatric Residential Treatment Facilities.
Approval Date: June 6, 2013
Effective Date: September 4, 2013
Topics: Financing & Reimbursement

Wisconsin
Revises reimbursement methodology for inpatient hospital services.
Approval Date: June 6, 2013
Effective Date: July 1, 2012
Topics: Financing & Reimbursement Program Administration