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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 8821 - 8830 of 15862

Minnesota
Removes the option for recovery of all medical assistance services from the estates of deceased individuals who received services at and after age 55, and limits recovery to nursing facility services, home and community-based services and associated hospital and prescription drug service.
Approval Date: December 20, 2016
Effective Date: July 1, 2016

Vermont
To increase reimbursement to primary care physicians by increasing the conversion factor used for primary care services payable under the RB RVS methodology.
Approval Date: December 20, 2016
Effective Date: October 1, 2016

New York
To continue a pay for performance quality incentive payment program for non-specialty nursing facilities and a related proportional rate reduction.
Approval Date: December 19, 2016
Effective Date: April 1, 2015

Massachusetts
This SPA was submitted to revise your approved Title XIX State plan to update the language regarding clinic services.
Approval Date: December 19, 2016
Effective Date: April 1, 2016

New Hampshire
Recovery Audit Contract (RAC) Exception.
Approval Date: December 19, 2016
Effective Date: January 1, 2017

Ohio
Updates the terms upon which the state intends to collect supplemental rebates from drug manufacturers.
Approval Date: December 19, 2016
Effective Date: January 1, 2017

Oregon
Defines optometrists as "physicians" in the state of Oregon for Medicaid billing and services, which makes them eligible providers for the Electronic Health Record (EHR) Incentive Program.
Approval Date: December 19, 2016
Effective Date: July 1, 2016

Wisconsin
Revises reimbursement methodology for NF and ICF/DD services.
Approval Date: December 19, 2016
Effective Date: July 1, 2016

Washington
To transition most of the responsibility for third party recoveries to managed care plans and to begin enrollment into Apple Health managed care for those Medicaid clients who have third party coverage.
Approval Date: December 19, 2016
Effective Date: January 1, 2017

Missouri
Increases nursing facility (NF) and HIV NF per diem rates by $1.61 effective for dates of service beginning August 1, 2019. Then, for dates of service beginning July 1, 2020, the per diem increase is reduced to an increase of $1.49 per day.
Approval Date: December 19, 2016
Effective Date: August 1, 2019