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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 9671 - 9680 of 15875

Washington
Clarifies the reimbursement methodologies for claims paid under the fee-for-service Prescription Drug Program and describes the reimbursement methodology for drugs paid under the Physician Services program.
Approval Date: December 18, 2015
Effective Date: July 1, 2015

Alaska
This SPA changes the state from accepting eligibility assessment to accepting eligibility determination for Medicaid made by the Federally Facilitated Marketplace.
Approval Date: December 17, 2015
Effective Date: November 1, 2015

Michigan
Updates the Michigan Department of Community Health Indigent Care Agreement DSH Pool Eligible Hospitals and Allocations Appendix B.
Approval Date: December 17, 2015
Effective Date: September 30, 2015

New York
Maintains supplemental payments to private hospitals for state fiscal years 2013 and 2014.
Approval Date: December 17, 2015
Effective Date: April 1, 2012

South Carolina
Establishes that one or more qualified hospitals are determining presumptive eligibility, and that the state is providing coverage for individuals determined presumptively eligible, in accordance with the Affordable Care Act.
Approval Date: December 17, 2015
Effective Date: January 1, 2014
Topics: Benefits Program Administration

Georgia
Revises the payment methodology for nursing facility services.
Approval Date: December 17, 2015
Effective Date: July 1, 2015
Topics: Financing & Reimbursement Program Administration

Wisconsin
Revises reimbursement methodologies for inpaitent hospital access payment rates and reorganizes the state plan to make information flow more logically.
Approval Date: December 17, 2015
Effective Date: January 1, 2015
Topics: Financing & Reimbursement Program Administration

Alaska
This SPA freezes rates for SFY 2016 for inpatient hospital, long-term care facility, nursing facility, federally-qualified health care centers, and the infant learning targeted case management at SFY 2015 levels.
Approval Date: December 17, 2015
Effective Date: July 1, 2015

Ohio
Payment for Services: Removal of the Medicare Part B cost-sharing exemption for physician services.
Approval Date: December 17, 2015
Effective Date: January 1, 2016
Topics: Cost Sharing Financing & Reimbursement

Minnesota
Increases payment rates for home health care services.
Approval Date: December 16, 2015
Effective Date: July 1, 2015