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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 8561 - 8570 of 15862

Delaware
This amendment clarifies the limitation on agents used for cosmetic purposes or hair growth will only be covered when the state has determined that use to be medically necessary.
Approval Date: April 19, 2017
Effective Date: January 1, 2017
Topics: Benefits Program Administration

Alaska
This SPA updates reimbursement rates for inpatient psychiatric services for individuals under the age of 21, removes language restricting eligible providers to non-profits, removes language targeting individuals with a serious emotional disturbance for service eligibility, and corrects a previous error of placement of this reimbursement methodology in Attachment 4.19-8.
Approval Date: April 18, 2017
Effective Date: July 1, 2017
Topics: Financing & Reimbursement Program Administration

Washington
This SPA updated the fee schedules for Ambulatory Surgery Centers (ASC), Dental services, Home health services, Outpatient Prospective Payment Systems (OPPS), and Outpatient hospital Services.
Approval Date: April 17, 2017
Effective Date: January 1, 2017
Topics: Financing & Reimbursement Program Administration

Washington
To request a two year exception period to the federal requirement for a Recovery Audit Contractor (RAC).
Approval Date: April 17, 2017
Effective Date: July 16, 2016

Idaho
Updates the optional state supplement standards for special income level groups consistent with the published 2017 federal poverty levels.
Approval Date: April 17, 2017
Effective Date: January 1, 2017
Topics: Financing & Reimbursement Program Administration

Washington
This SPA removes the three-day and five-day limitations on alcohol and substance-related medical withdrawal management stays. Medical withdrawal management stays will be based on medical necessity and no longer require exception to rule requests.
Approval Date: April 17, 2017
Effective Date: January 1, 2017

Washington
Updates the optional state supplement standards for special income level groups incorporating the published 2017 Cost of Living Adjustments.
Approval Date: April 14, 2017
Effective Date: January 1, 2017
Topics: Financing & Reimbursement Program Administration

Indiana
Removes the twelve week coverage limitation for tobacco cessation services and adds optometrists, clinical social workers, marital and family counselors, mental health counselors, and licensed clinical addiction counselors to the practitioners who may provide tobacco dependence counseling services.
Approval Date: April 14, 2017
Effective Date: January 1, 2017
Topics: Benefits Program Administration

Ohio
Payment for Services: Home Health Nursing and PrivateDuty Nursing Services.
Approval Date: April 14, 2017
Effective Date: January 1, 2017

Rhode Island
Grants authority to provide Opioid treatment Centers of Excellence services in the fee for servicer delivery system, aligning with similar services now available in managed care under recent health home State Plan revisions.
Approval Date: April 14, 2017
Effective Date: November 1, 2016
Topics: Benefits Financing & Reimbursement