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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 6591 - 6600 of 15783

North Dakota
Proposes to revise coverage of investigational and over-the-counter drugs.
Approval Date: May 23, 2019
Effective Date: November 1, 2018
Topics: Program Administration

Connecticut
Incorporate the 2019 Healthcare Common HCPCS changes to the Independent Radiology and Independent Laboratory fee schedules to remain compliant with HIPPA as well as adding 49 new molecular pathology codes and 2 chemistry codes to the Independent Laboratory fee schedule.
Approval Date: May 23, 2019
Effective Date: January 1, 2019
Topics: Financing & Reimbursement Program Administration

Montana
Clarifies clinic reimbursement is based on a published fee schedule and includes a 3. 8% rate reduction that was necessary to meet UPL requirements.
Approval Date: May 23, 2019
Effective Date: July 1, 2013
Topics: Financing & Reimbursement

Montana
Reimbursement update for Clinic Services.
Approval Date: May 23, 2019
Effective Date: July 1, 2013
Topics: Financing & Reimbursement

Ohio
Compliance with 21st Century Cures Act requirement to publish fee-for-service provider directory on State Medicaid Agency's public website.
Approval Date: May 23, 2019
Effective Date: July 1, 2019
Topics: Financing & Reimbursement

New York
SPA extends the Ambulatory Patient Group (APG) methodology for hospital based clinic & ambulatory surgery services.
Approval Date: May 22, 2019
Effective Date: January 1, 2019
Topics: Program Administration

Vermont
Update the substance use disorder services language.
Approval Date: May 22, 2019
Effective Date: March 29, 2019
Topics: Program Administration

Maine
Modifies supplemental payments for outpatient hospital reimbursement for outpatient hospital services.
Approval Date: May 22, 2019
Effective Date: May 3, 2018
Topics: Financing & Reimbursement

Louisiana
Amend provisions governing reimbursementin the Pharmacy Benefits Management Program in order to increase professional dispense fee.
Approval Date: May 21, 2019
Effective Date: May 1, 2019
Topics: Program Administration

Ohio
Expands the Nursing Facilities ventilator program.
Approval Date: May 21, 2019
Effective Date: January 3, 2019
Topics: Financing & Reimbursement