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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 8571 - 8580 of 15862

Maine
Adds new dental codes to the Medicaid state plan.
Approval Date: April 14, 2017
Effective Date: September 1, 2015

Maine
Updates the payment methodology for chiropracto services to include radiology CPT codes for covered services.
Approval Date: April 14, 2017
Effective Date: January 1, 2016

Kansas
Establishes an exception from the requirement to participate in the Recovery Audit Contractor (RAC) program.
Approval Date: April 13, 2017
Effective Date: January 1, 2017
Topics: Financing & Reimbursement Program Administration

New York
To extend the NY Ambulatory Patient Group (APG) methodology for freestanding clinic and ambulatory surgery center services for the effective period January 1, 2015 through December 31, 2015.
Approval Date: April 13, 2017
Effective Date: January 1, 2015
Topics: Benefits Program Administration

Maryland
This SPA updates Maryland's State Plan to change methadone reimbursement to better align services delivered with payment.
Approval Date: April 13, 2017
Effective Date: April 3, 2017

Minnesota
Updates the state plan to include utilization from participating MCOs for supplemental drug rebates for direct-acting antivirals for the treatment of hepatitis C.
Approval Date: April 12, 2017
Effective Date: January 1, 2017

New York
Eliminates the two percent (2%) Across-the-Board reduction for payments made under the State's non-institutional State Plan. However, this SPA does not eliminate the 2% Across-the-Board reduction for services provided by freestanding clinic providers.
Approval Date: April 12, 2017
Effective Date: April 1, 2014

Alaska
This SPA removes the section of the State Plan titled Telemedicine Applications, as telemedicine is not a1905(a) service but instead a service delivery method and it is not required on the plan page.
Approval Date: April 12, 2017
Effective Date: April 1, 2017

Utah
Revise's Utah pharmacy reimbursement methodology to comply with the key provisions of the Covered Outpatient Drug Final Rule with Comment( 81 FR 5170) that was published in the Federal Register on February 1, 2016.
Approval Date: April 12, 2017
Effective Date: April 1, 2017

Louisiana
Amends the reimbursement methodology for outpatient hospital services to increase Medicaid reimbursement rates paid to non-rural, non-state hospitals and children's specialty hospitals.
Approval Date: April 12, 2017
Effective Date: January 1, 2017