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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 12901 - 12910 of 15693

Rhode Island
This SPA approves the transition of the single -state agency designation from the Department or Human services (DHS) to the Executive Office of Health and Human Services (EOHHS).
Approval Date: August 2, 2012
Effective Date: July 1, 2011
Topics: Program Administration

Connecticut
This SPA proposed to amend the maximum allowable cost for selected multi-source brand and generic drugs to range from average wholesale price (A WP) minus 72 percent to step down tiers through A WP minus 20 percent based on meeting specific invoice pricing criteria.
Approval Date: August 2, 2012
Effective Date: November 1, 2011

New York
Continued reduction to Inpatient statewide base price (FMAP=50%).
Approval Date: August 1, 2012
Effective Date: May 1, 2012
Topics: Financing & Reimbursement

Utah
Provider Preventable Conditions.
Approval Date: August 1, 2012
Effective Date: July 1, 2012

Michigan
This amendment revises the long term care provider appeals process.
Approval Date: August 1, 2012
Effective Date: April 1, 2012
Topics: Program Administration

Idaho
This SPA amends Idaho's current 1915(i) State plan benefit by adding clarifying language to the services available to eligible participants. In addition, this SPA adds language to indicate that on June 30, 2013, Intensive Behavioral Intervention (IBI), IBI consultation, Developmental Therapy (DT), and Children's Service Coordination (CSC) will sunset in Idaho's Basic and Enhanced Benchmark Benefit plans.
Approval Date: July 31, 2012
Effective Date: June 1, 2012

Missouri
Was in response to the companion letter issued with the approval of SPA 10-14. The companion letter had requested a number of revisions to the State Plan which were needed to bring the provision for targeted case management into compliance with current policy.
Approval Date: July 27, 2012
Effective Date: October 1, 2011

Missouri
Amends MO HealthNet's reimbursement of outpatient radiology procedures to be reimbursed from a Medicaid fee schedule, effective for service dates beginning October 1, 2011, for all MO HealthNet enrolled hospitals. This amendment also provides a 5% increase to the prospective outpatient rate for federally-designated Critical Access Hospitals for service dates October 1, 2011 through June 30, 2012.
Approval Date: July 27, 2012
Effective Date: October 1, 2011

West Virginia
Implements Process for Screening Providers and Suppliers and Creates Temporary Enrollment Moratorium for Certain Providers.
Approval Date: July 27, 2012
Effective Date: April 1, 2012

District of Columbia
This SPA implements regulations for provider preventable conditions and related payment adjustments for Medicaid.
Approval Date: July 26, 2012
Effective Date: July 1, 2012
Topics: Financing & Reimbursement