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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 8261 - 8270 of 15919

New York
The SPA proposes to carve out the administration of the Long-Acting Reversible Contraceptive (LARC) from the APG reimbursement methodology when it is provided on the same Date of Service (DOS) as an abortion.
Approval Date: September 1, 2017
Effective Date: July 1, 2013

Louisiana
This state plan amendment proposes to amend the provisions governing reimbursement for professional services in the Medical Assistance program to establish provisions governing a one percent Federal Medical Assistance Percentage (FMAP) point increase for the coverage of specific adult vaccines and clinical preventative services provided on a fee for service or managed care basis.
Approval Date: September 1, 2017
Effective Date: May 15, 2017

Virginia
This SPA will allow Virginia to add the new annuity requirement that annuities purchased before February 8, 2006, but modified after that date would be subject to all requirements applicable to annuities purchased after February 8, 2006.
Approval Date: September 1, 2017
Effective Date: July 27, 2017

Iowa
This SPA is adjusting the Medicaid reimbursement rates for physician services by applying a site of service differential to reflect the difference between the cost of physician services when provided in a health care facility setting and the cost of physician's services when provided in the physician's office.
Approval Date: August 31, 2017
Effective Date: July 1, 2017

Georgia
Increases the reimbursement for specialized nursing home ventilator care.
Approval Date: August 31, 2017
Effective Date: July 1, 2017

California
This SPA was submitted to my office on September 16, 2016 to request an exception from renewing the Recovery Audit Contractor (RAC) under Section 1902(a)(42)(B)(i) of the Social Security Act once the agreement expires on January 1, 2017. CMS is granting this exception request based on the documentation provided by the Department that it has active program integrity contractors performing work similar to RAC.
Approval Date: August 31, 2017
Effective Date: January 1, 2017
Topics: Financing & Reimbursement Program Administration

South Dakota
This amendment updates the outpatient hospital reimbursement.
Approval Date: August 31, 2017
Effective Date: July 1, 2017

Alaska
This SPA proposes to bring Alaska into compliance with the reimbursement requirements in the Covered Outpatient Drug final rule with comment period (CMS-2345-FC).
Approval Date: August 31, 2017
Effective Date: April 1, 2017

New York
This amendment proposes to continue reimbursement for Medicaid's portion of a provider tax on nursing home gross receipts and maintain various cost containment measures that otherwise would have expired.
Approval Date: August 31, 2017
Effective Date: April 1, 2015

New York
This amendment proposes to limit the trend factor for inpatient hospital services to an amount no greater than zero for services provided on and after April 1,2017 through March 31, 2019.
Approval Date: August 31, 2017
Effective Date: April 1, 2017
Topics: Benefits Financing & Reimbursement