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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 11801 - 11810 of 15708

New York
The SPA implements April 2010 revisions to the Clinic Ambulatory Patient Group reimbursement methodology and imposes a 2 percent reduction on payment rates for Early Intervention services.
Approval Date: November 7, 2013
Effective Date: April 1, 2011
Topics: Financing & Reimbursement Program Administration

Nebraska
Revises the state plan pages to include an assurance statement that rehabilitative services are not provided to adults in institutions for mental diseases.
Approval Date: November 7, 2013
Effective Date: September 1, 2013

Washington
Increases the seventeen levels of Medicaid payment rates by $0.14 for licensed Adult Family Homes serving Medicaid clients.
Approval Date: November 6, 2013
Effective Date: July 1, 2013
Topics: Financing & Reimbursement

New York
Changes the service limits for comprehensive tobacco cessation services provided to pregnant women, including both counseling and pharmacotherapy, without cost sharing.
Approval Date: November 6, 2013
Effective Date: October 1, 2013
Topics: Benefits Cost Sharing Program Administration

Idaho
Incorporates the Modified Adjusted Gross Income (MAGI) Based Methodologies.
Approval Date: November 6, 2013
Effective Date: January 1, 2014

Pennsylvania
Prescribed Drugs Supplemental Drug Rebate Agreement.
Approval Date: November 6, 2013
Effective Date: October 1, 2013
Topics: Financing & Reimbursement Prescription Drugs

Kentucky
Removes the four prescription limit for the pharmacy benefit and also removes the Behavioral Pharmacy Management Program from the State Plan as the program no longer exists.
Approval Date: November 6, 2013
Effective Date: January 1, 2014
Topics: Benefits Prescription Drugs

Rhode Island
Opioid Treatment Program Health Home Services.
Approval Date: November 6, 2013
Effective Date: July 1, 2013

Louisiana
The state plan amendment reduces the reimbursement rates for intermittent and extended nursing services and home health aide services in the Home Health Program by 3.7 percent.
Approval Date: November 6, 2013
Effective Date: July 1, 2012
Topics: Financing & Reimbursement

Michigan
Revises the National Medicaid Pooling Initiative Supplemental Rebate Agreement.
Approval Date: November 6, 2013
Effective Date: October 1, 2013
Topics: Program Administration