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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 12831 - 12840 of 15696

New York
Reduce Reimbursement for Other Provider Preventable Conditions (OPPCs) FMAP = 50% 7/1/11 forward).
Approval Date: September 6, 2012
Effective Date: July 1, 2011
Topics: Financing & Reimbursement

New Jersey
By means of this SPA, New Jersey brings its State Plan into compliance with Section 1903(r) of the Act and 42 CFR 435.960, which requires States to have an eligibility determination system that provides data matching with other State's medical assistance systems through the Public Assistance Reporting Information System (PARIS). New Jersey began using PARIS in 2008.
Approval Date: September 6, 2012
Effective Date: April 1, 2012

New York
This amendment implements regulations for Provider Preventable Conditions (PPCs) and related payment adjustments for Medicaid and incorporates the CMS pre-print for PPCs for outpatient services into Attachment B. New York implemented the CMS pre-print for inpatient services in Attachment A under TN 11-046-A, approved on May 25, 2012.
Approval Date: September 6, 2012
Effective Date: July 1, 2011

New York
This SPA will expand targeted case management services to Onondaga County to permit a nurse, who does not have a Bachelor's of Science in Nursing, but who is bilingual and enrolled in a Bachelor's degree program in nursing, to serve as a case manager to an underserved population.
Approval Date: September 6, 2012
Effective Date: January 1, 2012

Utah
Reinstate emergency dental services to non-pregnant adults who are 21 years of age or older.
Approval Date: September 6, 2012
Effective Date: July 1, 2012

Puerto Rico
Obtains payment from third party resources.
Approval Date: September 6, 2012
Effective Date: April 1, 2012

Arkansas
The plan amendment implements a payment improvement initiative which provides positive incentive adjustments in the form of gain sharing to reward providers who succeed in delivering higher, quality, patient-centered, and cost-effective care for designated episo9des of care and requires providers who do not meet the cost of care and or quality thresholds to make risk-sharing payments back to the Medicaid agency.
Approval Date: September 6, 2012
Effective Date: October 1, 2013

Louisiana
The plan amendment terminates the original Program Community Care (PCCM) in the state of Louisiana. The amendment change does not have a direct impact on Indians, Indian Health programs, or Urban Indian organizations.
Approval Date: September 5, 2012
Effective Date: June 1, 2012

Utah
Reimbursement for Physician and Anesthesia Services.
Approval Date: September 4, 2012
Effective Date: July 1, 2012
Topics: Financing & Reimbursement

Pennsylvania
Revises the rate methodologies for targeted case management services.
Approval Date: September 1, 2012
Effective Date: July 1, 2012