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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 10921 - 10930 of 15886

Colorado
Offers Medicaid Coverage for Individuals Determined Presumptively Eligible by a Qualified Hospital.
Approval Date: July 21, 2014
Effective Date: January 1, 2014

Oregon
This SPA describes the methodology used by the state for determining the appropriate FMAP rates, including the increased FMAP rates, available under the provisions of the ACT for the medical assistance expenditures under the Medicaid program associated with enrollees in the new adult group adopted by the state.
Approval Date: July 21, 2014
Effective Date: January 1, 2014
Topics: Financing & Reimbursement Program Administration

Oregon
This SPA reflects that an applicant or recipient must cooperate in identifying any third party who may be liable to pay for care under assignment of rights in the Medicaid state plan.
Approval Date: July 21, 2014
Effective Date: July 1, 2014

Pennsylvania
Requires states to affirm citizen regulations, specify reasonable opportunity options and specify policy options related to immigrant eligibility.
Approval Date: July 21, 2014
Effective Date: October 1, 2013

West Virginia
This SPA modifies Attachments 4.19-A and 4.19B of West Virginia's Title XIX State Plan. Specifically, SPA 12-010 implements regulations for provider preventable conditions and related payment adjustments for Medicaid.
Approval Date: July 19, 2014
Effective Date: July 1, 2014

Pennsylvania
This amendment reflects changes in the prior authorization policy for pharmacy services.
Approval Date: July 17, 2014
Effective Date: July 8, 2014

Louisiana
The SPA proposes to comply with the federal requirements of the Affordable Care Act with regards to hospice. The amendment also revises the provisions governing prior authorization for hospice services in order to control escalating costs associated with the hospice program.
Approval Date: July 17, 2014
Effective Date: November 20, 2013
Topics: Financing & Reimbursement Managed Care

Utah
This State Plan Amendment updates the effective date of rates for home health services to 7/1/14.
Approval Date: July 17, 2014
Effective Date: July 1, 2014

Utah
This State Plan Amendment updates the effective date of rates for Physician/ Anesthesiology services to 7/1/14.
Approval Date: July 17, 2014
Effective Date: July 1, 2014

Utah
This State Plan Amendment updates the effective date of rates for Optometrist services to 7/1/14.
Approval Date: July 17, 2014
Effective Date: July 1, 2014