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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 6621 - 6630 of 15783

Mississippi
Submitted to correspond with the new NET Broker contract, operational.
Approval Date: May 9, 2019
Effective Date: February 1, 2019
Topics: Financing & Reimbursement

Mississippi
Allows the Mississippi Division of Medicaid to: a) add Autism Spectrum Disorder (ASD) as a covered diagnosis, b) remove the needs-based criteria, c) revise the qualifications and training requirements for Targeted Case Managers, and d) revise the reimbursement for TCM for beneficiaries with IDD in community-based settings from $14.88 per fifteen (15) minute unit to a rate of $151.01 per month.
Approval Date: May 9, 2019
Effective Date: January 1, 2019
Topics: Financing & Reimbursement

South Carolina
FFY 2018 DSH Payment Methodology, SCDMH Hospital FFY 2018 Rate update, and Inpatient and Outpatient UPL Language updates.
Approval Date: May 9, 2019
Effective Date: October 1, 2017
Topics: Financing & Reimbursement

New York
The state is revising its policies to allow individuals to re-certify up to the last day of the month of the enrollment period. The state is also documenting transition of children into the State of Health (state's marketplace) for re-enrollment rather than going through the plans.
Approval Date: May 9, 2019
Effective Date: April 1, 2018
Topics: Program Administration

Oklahoma
Revises the state plan to comply with federal regulations and reflect that children under twenty-one (21) years of age, who are residing in an inpatient psychiatric facility must be provided all medically necessary services.
Approval Date: May 7, 2019
Effective Date: January 1, 2019

Texas
Updates the physicians' and other practitioners' state plan pages by identifying the new conversion factor (CF) for anesthesia services provided by certain children's hospitals.
Approval Date: May 7, 2019
Effective Date: March 1, 2019

Nebraska
Changing the current limitations of beds allowed in a therapeutic group home from eight to sixteen.
Approval Date: May 7, 2019
Effective Date: January 1, 2019
Topics: Program Administration

Virginia
Allow residents in professional counseling, psychology and supervisees in social work who completed the education requirements for licensure but have yet to meet the experience requirements to provide billable outpatient behavioral health services to Medicaid members. Removed also is the 21-day limit on inpatient psychiatric services.
Approval Date: May 6, 2019
Effective Date: January 1, 2019
Topics: Financing & Reimbursement Program Administration

Washington
Update to add the non-MAGI methodologies.
Approval Date: May 3, 2019
Effective Date: January 1, 2019
Topics: Program Administration

South Carolina
Rates changes established under the final Medicare Hospice Rule published August 6, 2015 (CMS-1629-F).
Approval Date: May 3, 2019
Effective Date: January 1, 2016
Topics: Financing & Reimbursement