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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 10661 - 10670 of 15777

Iowa
Amends fee schedule reimbursement for ambulance services.
Approval Date: September 18, 2014
Effective Date: July 1, 2014
Topics: Financing & Reimbursement

Oregon
Modifies the rate methodology for the Programs for the All-Inclusive Care of the Elderly (PACE) aligning payment with the Oregon Health Authority's (OHA) performance-based reimbursements.
Approval Date: September 17, 2014
Effective Date: April 1, 2014
Topics: Financing & Reimbursement

Pennsylvania
(A1-A3), "Single State Agency," addresses single state agencies delegation of appeals and determinations.
Approval Date: September 17, 2014
Effective Date: April 1, 2014
Topics: Program Administration

Wyoming
This SPA concerns the implementation of a Primary Care Medical Home through a voluntary PCCM authority to allow for Wyoming Medicaid to pay the PCCM entities a Per Member/Per Month case management fee for managing the health care needs in a primary care medical home setting and for reporting quality measures to the State, in addition to payments made on a FFS basis.
Approval Date: September 17, 2014
Effective Date: October 1, 2014
Topics: Financing & Reimbursement Program Administration

Illinois
Allows out of state trauma centers to be eligible for Trauma Center Adjustments; limits the Medicaid Percentage Adjustment payment $155 per day for a children's hospital and $215 for all other hospitals other than those hospitals organized under the University of Illinois Act; limits Direct Hospital Adjustment payments to $69 per day for Illinois teaching hospitals with 25 or more graduate medical programs that are affiliated with a Regional Alzheimer's Disease Assistance Center designated by the Alzheimer's Disease Assistance Act, that has an MIUR less than 25% on July 1, 1999, and provided 75 or more Alzheimer days for patients diagnosis as having the disease.
Approval Date: September 16, 2014
Effective Date: December 1, 2008
Topics: Financing & Reimbursement Program Administration

Michigan
Updates inpatient hospital rates through a diagnosis related group and assigned relative weight update.
Approval Date: September 16, 2014
Effective Date: January 1, 2014
Topics: Financing & Reimbursement

Minnesota
Revises methodologies and standards for Inpatient Hospital rates.
Approval Date: September 16, 2014
Effective Date: July 1, 2013
Topics: Financing & Reimbursement

Wisconsin
Revises reimbursement methodology for NF and ICF/DD services.
Approval Date: September 16, 2014
Effective Date: July 1, 2013

Utah
This State Plan Amendment updates the utilization trend used for the outpatient hospital UPL.
Approval Date: September 16, 2014
Effective Date: July 1, 2014
Topics: Financing & Reimbursement Program Administration

Montana
This SPA updates Montana' s fee schedule for Free Standing Birthing Center Services which includes an approximate rate increase of 9.7%.
Approval Date: September 16, 2014
Effective Date: July 1, 2014
Topics: Financing & Reimbursement