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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 11711 - 11720 of 15998

California
Provides Medi Cal providers that are qualifying 340B eligible covered entities and purchase drugs through the 340B drug pricing program to bill an amount not to exceed the entity's actual acquisition cost for the drug plus a professional fee for dispensing of 7dollars and twenty cents.
Approval Date: January 30, 2014
Effective Date: February 23, 2012
Topics: Benefits Financing & Reimbursement Prescription Drugs Program Administration

California
Increases the payment rate for specific drugs, categories of drugs and certain pharmacies andwould reverse in certain circumstances the ten percent payment reduction that was approved through SPA 11-009.
Approval Date: January 30, 2014
Effective Date: March 31, 2012
Topics: Financing & Reimbursement Prescription Drugs Program Administration

Nevada
Clarifies the reimbursement methodology for Federally Qualified Health Centers and Rural Health Clinics and to describe the change in scope process required for a rate review.
Approval Date: January 30, 2014
Effective Date: July 1, 2013
Topics: Financing & Reimbursement Program Administration

New York
Implement an expanded definition of terminal illness such that an individual who is certified by a physician as terminally ill with a life expectancy of twelve months or less is eligible to elect the hospice benefit effective.
Approval Date: January 29, 2014
Effective Date: April 1, 2012

Michigan
MAGI Based Income Methodologies.
Approval Date: January 29, 2014
Effective Date: January 1, 2014

Montana
Amends Physician Services to update Fees by 5.7% and the date of Fee Schedule.
Approval Date: January 29, 2014
Effective Date: July 1, 2013

New York
Supplemental payments to certain providers for inpatient hospital services.
Approval Date: January 28, 2014
Effective Date: November 1, 2013

New York
Enact a 2% uniform reduction across most hospital inpatient payments for acute care services provided on or after April 1, 2013 through March 31, 2015.
Approval Date: January 28, 2014
Effective Date: April 1, 2013

Puerto Rico
Changes the service limits for comprehensive tobacco cessation services provided to pregnant women including both counseling and pharmacotherapy, without cost sharing.
Approval Date: January 28, 2014
Effective Date: October 1, 2013
Topics: Benefits Cost Sharing Eligibility Prescription Drugs Program Administration

Louisiana
Changes the criteria and reimbursement methodology for outpatient hospital services in order to makie Terrebonne General Hospital Qualify for the supplemental payment that West Jerrerson is current receiving.
Approval Date: January 28, 2014
Effective Date: July 1, 2013