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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 12551 - 12560 of 15764

Ohio
Removes the benefit limit for partial hospitalization services provided by community mental health facilities.
Approval Date: February 13, 2013
Effective Date: October 1, 2012

Utah
Physician Services Reimbursement, specifically psychiatric pharmacologic management.
Approval Date: February 13, 2013
Effective Date: January 1, 2013

Vermont
Updates the Outpatient Prospective Payment System (OPPS) to align with Medicare's national median rates except as specified in the State Plan.
Approval Date: February 12, 2013
Effective Date: January 1, 2012

Pennsylvania
Places prescription quantity limits, for recipients 21 years of age and older, to six prescriptions per calendar month.
Approval Date: February 12, 2013
Effective Date: January 3, 2012

Rhode Island
Implements Section 2702 of the Affordable Care Act. Adjustments for identified hospital Acquired Conditions and Other Provider Preventable Conditions in hospitals and other health care settings.
Approval Date: February 11, 2013
Effective Date: January 11, 2013
Topics: Financing & Reimbursement Program Administration

Louisiana
Under this SPA, the state proposes to revise the current pharmacy reimbursement methodology for the ingredient cost from average wholesale price (AWP) minus 13% for independent pharmacies and AWP minus 15% for chain pharmacies to average acquisition cost (AAC).
Approval Date: February 8, 2013
Effective Date: September 5, 2012
Topics: Financing & Reimbursement

Indiana
Implements a Program of All-Inclusive Care for the Elderly.
Approval Date: February 8, 2013
Effective Date: October 1, 2012

Wisconsin
Medicaid administration for vaccine administration.
Approval Date: February 8, 2013
Effective Date: January 1, 2013

Colorado
Excludes from coverage benzodiazepines for all conditions and barbiturates for the treatment of epilepsy, cancer and chronic mental health disorders for full benefit duel eligible as Medicare Part D will provide this coverage.
Approval Date: February 7, 2013
Effective Date: January 1, 2013
Topics: Benefits Prescription Drugs Program Administration

South Carolina
This SPA This SPA reflects changes in pharmacy coverage required by Section 175 of the Medicare improvement for Patients and Providers.
Approval Date: February 7, 2013
Effective Date: January 1, 2013