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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 12521 - 12530 of 15706

Texas
This state plan amendment updates the fee schedule for durable medical equipment, prosthetics, orthotics, and supplies.
Approval Date: January 29, 2013
Effective Date: October 1, 2012

Iowa
Implements an AAC reimbursement methodology for all drugs, replacing the AWP, SMAC & nonprescription drug methodologies. Where AAC isnt available, WAC will be utilized. dispensing fee is set at $10.02 based on survey completion by all pharmacies.
Approval Date: January 29, 2013
Effective Date: February 1, 2013
Topics: Financing & Reimbursement Program Administration

North Carolina
Removes old outpatient behavioral health HCPCS codes from the coverage section of the state plan and adds outpatient behavioral health services provided by direct enrolled providers to the EPSDT section of the state plan. It also adds definitions for these services for children and adults.
Approval Date: January 29, 2013
Effective Date: January 1, 2012

Wisconsin
Health Home.
Approval Date: January 29, 2013
Effective Date: October 1, 2012

Hawaii
New provider screening and enrollment requirements.
Approval Date: January 29, 2013
Effective Date: October 1, 2012

Alabama
Removes the waiver of services related to the treatment of a terminal illness required when a beneficiary under the age of 21 elects hospice services.
Approval Date: January 29, 2013
Effective Date: December 1, 2012

Alabama
Increases Durable Medical Equipment (DME) provider reimbursement to 80% of Medicare's allowed amount.
Approval Date: January 29, 2013
Effective Date: November 1, 2012

Virginia
Propose to repeal Elderly Case Management.
Approval Date: January 29, 2013
Effective Date: January 1, 2013

Alabama
Removes the waiver of services related to the treatment of a terminal illness required when a beneficiary under the age of 21 elects hospice services.
Approval Date: January 29, 2013
Effective Date: December 1, 2012

Alabama
Increases Durable Medical Equipment (DME) provider reimbursement to 80% of Medicares allowed amount.
Approval Date: January 29, 2013
Effective Date: November 1, 2012