U.S. flag

An official website of the United States government

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 10581 - 10590 of 15883

Louisiana
Increases the dispensing fee from $10.13 to $10.51 per prescription.
Approval Date: December 2, 2014
Effective Date: November 1, 2012
Topics: Financing & Reimbursement Prescription Drugs

Arizona
ABP Updates benefits to add insuline pumps.
Approval Date: December 2, 2014
Effective Date: October 1, 2014
Topics: Benefits Program Administration

South Carolina
This SPA updates the coverage criteria for Preventative Services.
Approval Date: December 2, 2014
Effective Date: September 1, 2014

Alabama
Discontinue the Certified Public Expenditure (CPE) program for State and Non State governmental hospital facilities and to implement plan authority for an Upper Payment Limit (UPL) program for State and Non-State governmental hospitals.
Approval Date: December 2, 2014
Effective Date: October 1, 2013
Topics: Financing & Reimbursement Program Administration

Wisconsin
Outpatient Hospital Rates.
Approval Date: December 2, 2014
Effective Date: January 1, 2014

Arizona
This SPA updates the State Plan section on third party liability to reflect recent internal changes to third party liability claims processing, including diagnosis & trauma code edits, availability of other insurance coverage, determination of correct billing and other related changes.
Approval Date: December 2, 2014
Effective Date: July 1, 2014

Delaware
Standards for coverage of organ transplant services by adding "Intestinal transplant" to the list of transplant procedures to reflect long-standing practice.
Approval Date: December 2, 2014
Effective Date: August 1, 2014
Topics: Benefits Program Administration

Washington
Updates the nursing facility rates SFY 2015.
Approval Date: December 1, 2014
Effective Date: July 1, 2014

Utah
Kinship Guardianship Coverage.
Approval Date: December 1, 2014
Effective Date: November 25, 2014
Topics: Benefits Eligibility Program Administration

Illinois
This SPA eliminates the add-on reimbursement for delivery of psychiatric rehabilitation services to individuals with mental illness residing in nursing facilities, which was $10 per day.
Approval Date: December 1, 2014
Effective Date: July 1, 2012