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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 10701 - 10710 of 15883

Illinois
Proposes to allow federal qualified health centers (FQHCs) and rural health clinics (RHCs) to be reimbursed under an alternate payment methodology for Long Acting Reversible Contraceptives (LARCs) and non-surgical, transcervical permanent female contraceptive devices.
Approval Date: October 17, 2014
Effective Date: October 1, 2014
Topics: Financing & Reimbursement Prescription Drugs Program Administration

Texas
This state plan amendment provides the requirements for establishing residency in a state for Medicaid eligibility in accordance with the Patient Protections and Affordable Care Act (PPACA).
Approval Date: October 16, 2014
Effective Date: January 1, 2014

Louisiana
This state plan amendment revises the provisions governing thereimbursement methodology in the Professional Services Program in order to discontinue reimbursement for elective deliveries performed prior to 39 weeks gestation when there is no documentation of a medical condition that would justify elective delivery.
Approval Date: October 16, 2014
Effective Date: August 20, 2014
Topics: Financing & Reimbursement Program Administration

South Carolina
This state plan amends the coverage language regarding Medicaid or other remedial care provided by licensed practitioners to include Dietitians. Additionally, it clarifies payment methodology for various practitioner services to meet standards for comprehensiveness.
Approval Date: October 16, 2014
Effective Date: April 1, 2013

New Jersey
Establishes a new pathway (Miller Trust) for medically needy categories to establish Medicaid eligibility.
Approval Date: October 16, 2014
Effective Date: December 1, 2014

Texas
Updates the physicians and other practitioners' fee schedules.
Approval Date: October 16, 2014
Effective Date: July 1, 2014

Tennessee
Incorporates the MAGI-based eligibility process requirements into Tennessee's Medicaid state plan in accordance with the Affordable Care Act.
Approval Date: October 15, 2014
Effective Date: January 1, 2014

Idaho
This amendment revises the Medicare/Medicaid Coordinated Plan to comply with the requirements of the Affordable Care Act to ensure that the essential health benefits and other standards are met.
Approval Date: October 15, 2014
Effective Date: July 1, 2014

Nebraska
Transitions the inpatient hospital reimbursement methodology to one based on the all patient refined diagnosis related groups.
Approval Date: October 15, 2014
Effective Date: July 1, 2014

Maryland
Provides community-based treatment and suppori to children and youth with serious emotional disturbance and their families through a wraparound service delivery model.
Approval Date: October 14, 2014
Effective Date: October 1, 2014
Topics: Benefits Program Administration