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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.

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Displaying 13041 - 13050 of 15693

Wisconsin
This amendment revises methodology for periodically adjusting payment rates to reflect changes in case mix; updates the RUGS Grouper version; revises the type of debt recognized for purposes of determining allowable interest expense; increases the aggregate amount of supplemental payments to NFs operated by Local units of government; increases the alternate rate for ventilator dependent patients that have been transferred from a hospital to a NF; revises inflation, deflation, and labor factors, as well as the case mix weights for purposes of calculating the direct care allowance; increases the Medicaid access incentive for ICF/MRs.
Approval Date: June 4, 2012
Effective Date: July 1, 2011
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Louisiana
The plan amendment establishes supplemental payments for emergency medical transportation services rendered by land and air ambulance providers. The amendment change does not have a direct impact on Indians, Indian Health Programs, or Urban Indian organizations.
Approval Date: June 4, 2012
Effective Date: September 21, 2012
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Topics: Financing & Reimbursement
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North Dakota
Amends the State Plan to Implement the Resource Utilization Group (RUG) IV classification system, Identify the increase for nursing facility services, change the allowable education expense limit, identify salaries accrued at a facility's year end, but not paid within 75 days of The cost report yearend as an unallowable cost, and additional changes to provide for further detail on reporting requirement.
Approval Date: June 4, 2012
Effective Date: January 1, 2012
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Topics: Program Administration
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Virginia
Which the State establishes supplemental payments for services provided by physicians at Virginia freestanding children's hospitals with greater than 50 percent Medicaid inpatient utilization in state fiscal year 2009 for furnished services provided on or after July 1, 2011. The SPA also eliminates the 4 percent reduction for all procedures set through the resource-based relative value scale (RBRVS) process effective for dates of service on or after July 1, 2011. Additionally, the SPA adds information for calculating the physician supplemental payment amounts using the Medicare equivalent of the average commercial rate (ACR) methodology prescribed by CMS.
Approval Date: June 1, 2012
Effective Date: July 1, 2011
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New York
2011-12 Private Psychiatric Hospital (PPH) Rate Freeze (FMAP = 50%).
Approval Date: May 31, 2012
Effective Date: January 1, 2012
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Topics: Benefits
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New Jersey
Implementation of state upper payment limit for multi-source drugs.
Approval Date: May 31, 2012
Effective Date: May 19, 2011
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Topics: Financing & Reimbursement Prescription Drugs
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Maryland
This SPA updates the Stale plan to be consistent with CMS required format of separating inpatient Institutional reimbursement sections from outpatient I professional services. This update requires additional updating of all related service sections and are updated to reflect current practices and methods of reimbursement.
Approval Date: May 31, 2012
Effective Date: July 1, 2011
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Topics: Financing & Reimbursement
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South Dakota
This State Plan Amendment is submitted as required by Section 6401 (a) of the Affordable Care Act to establish procedures under which screening is conducted with respect to providers of medical or other items or services or supplier under Medicare, Medicaid and CHIP.
Approval Date: May 31, 2012
Effective Date: April 1, 2012
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Massachusetts
This amendment updates the methodology used to calculate payment rates for nursing facility services. Specifically it applies a total increase of $23.3 million to the current nursing facility user fee adjustment for fiscal year 2012 only; applies a total increaseof $3.7 million for an additional one-time add on payment based on each facility's user fee class; revises the determination of the Pediatric nursing facility rate based on 2006 cost reports instead of the most recently filed cost report; clarifies the criteria and documentation requirements for eligibility to receive P4P payments; and clarifies the provision for leave of absence days.
Approval Date: May 31, 2012
Effective Date: September 1, 2011
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Topics: Financing & Reimbursement
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Arkansas
The plan amendment is required by Section 6411 of the Affordable Care Act pertaining to the Medicaid Recovery Audit Contractor Program., where the state is requesting a time limited exception in order to complete the procurement process.
Approval Date: May 30, 2012
Effective Date: October 1, 2012
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