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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 8831 - 8840 of 15998

Connecticut
Changes the requirement for prescription refills to provide that a refill is allowed without prior authorization when the patient has consumed at least 93 percent of the original or latest refill prescription.
Approval Date: March 10, 2017
Effective Date: October 1, 2016

Connecticut
Authorizes supplemental payments to qualified small independent acute care hospitals in the amount of $11.8 million for state fiscal year 2017.
Approval Date: March 10, 2017
Effective Date: July 1, 2016

Connecticut
Authorizes supplemental payments to specified acute care hospitals in the amount of $105.7 million for state fiscal year 2017.
Approval Date: March 10, 2017
Effective Date: July 1, 2016

Maine
Removes barbiturates, benzodiazepines, and agents used to promote smoking cessation from the list of drugs the state Medicaid program may exclude from coverage or otherwise restrict in order to comply with the requirements of Section 2502 (a) of the Affordable Care Act.
Approval Date: March 10, 2017
Effective Date: January 1, 2014
Topics: Prescription Drugs Program Administration

Missouri
Provides annual assurance of the pharmacy program adherence to the requirements of the Federal Upper Limits (FUL) federal regulation for the time period October 1, 2015 through September 30, 2016.
Approval Date: March 10, 2017
Effective Date: October 1, 2016

Iowa
Implements a dispensing fee decrease from $11.73 to $10.02 per prescription, based on a recent cost of dispensing survey of Iowa Medicaid enrolled pharmacy providers.
Approval Date: March 10, 2017
Effective Date: August 1, 2016

Pennsylvania
Authorizes a supplemental payment to nonpublic and county nursing facilities that previously qualified for supplemental ventilator care or tracheostomy care payments in state fiscal year 2015.
Approval Date: March 10, 2017
Effective Date: December 11, 2016

Pennsylvania
Continues disproportionate share hospital payments to hospitals promoting access to inpatient hospital services for MA eligible and uninsured persons with cleft palate or craniofacial abnormalities.
Approval Date: March 10, 2017
Effective Date: December 11, 2016

Indiana
This state plan amendment modifies the reimbursement methodology for faculty physician access-to-care payment adjustments to comply with federal requirements and to extend the payment adjustments to eligible faculty physicians and eligible practitioners employed by or affiliated with eligible health institutions.
Approval Date: March 9, 2017
Effective Date: April 1, 2015

North Carolina
Including references to the federally recognized tribes (Eastern Band of Cherokee Indians), where appropriate, to ensure all duties, roles and responsibilities previously assigned to county divisions of social services are shared with the tribe for individuals living within the tribal boundary.
Approval Date: March 6, 2017
Effective Date: April 1, 2017