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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 9371 - 9380 of 15867

Wyoming
Changes the payment methodology for Non-emergency Transportation services provided by commercial carrier and for lodging to be based on fee schedule.
Approval Date: May 5, 2016
Effective Date: July 1, 2016
Topics: Financing & Reimbursement Program Administration

Utah
This Amendment only addresses the effective date of new FULs finalized in the Covered Outpatient Drug Rule.
Approval Date: May 4, 2016
Effective Date: May 1, 2016

Kentucky
This amendment modifies the State's reimbursement methodology for setting payment rates for hospital services.
Approval Date: May 4, 2016
Effective Date: October 1, 2015

Florida
This SPA revise the APR-DRG from version 31 to version 32. In addition, the amendment proposes to: increase the base inpatient DRG rate paid to hospitals, provide for an additional add-on payment for trauma centers, adjust the outlier marginal cost percentage, and provides for additional funding for the Statewide Residency Program.
Approval Date: May 4, 2016
Effective Date: July 1, 2015
Topics: Financing & Reimbursement Prescription Drugs Program Administration

Missouri
Adds Adult Dental coverage to the state plan.
Approval Date: May 4, 2016
Effective Date: January 1, 2016

Oregon
This SPA partially restores dental services (stainless stell crowns and dentures) for non-payment adults age 21 and over.
Approval Date: May 4, 2016
Effective Date: July 1, 2016

Florida
Removes outdated standards and incorporates the use of the American Academy of Pediatrics and Bright Futures Recommendations for Preventive Pediatric Health Care.
Approval Date: May 4, 2016
Effective Date: January 1, 2016

West Virginia
Modifies the State's methods and standards for reimbursement inpatient hospital services.
Approval Date: May 3, 2016
Effective Date: July 1, 2015

Florida
Adjusts reimbursement for Intermediate Care Facilities for Individuals with Intellectual Disabilities.
Approval Date: May 3, 2016
Effective Date: July 1, 2015

Texas
Removes the Medicaid State Plan page outlining the State's eligibility policy relating to recognition of marriage.
Approval Date: May 2, 2016
Effective Date: April 1, 2016