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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 13151 - 13160 of 15693

Texas
The amendment clarifies the circumstances under which a drug will be placed on the State's preferred drug list. The amendment does not have a direct impact on Indians, Indian Health programs, or Urban Indian organizations.
Approval Date: April 26, 2012
Effective Date: January 1, 2012

Texas
The plan amendment updates the administrative section of the state plan which includes the Single State Agency Organization, relations with Standard-setting and Survey agencies and the State Governor's review. The amendment does not have a direct impact on Indians, Indian Health programs, or Urban Indian organizations.
Approval Date: April 26, 2012
Effective Date: March 1, 2012

Texas
This plan amendment adds supplemental payments for dental services provided by publicly owned dental providers under the Early and periodic Screening, Diagnosis and Treatment program. The amendment does not have a direct impact on Indians, Indian Health programs, or Urban Indian organizations.
Approval Date: April 26, 2012
Effective Date: October 1, 2011

Washington
This amendment is a technical correction to the Medicaid State plan and makes no program or reimbursement changes.
Approval Date: April 26, 2012
Effective Date: October 1, 2011

Massachusetts
This SPA implemented the provider screening and enrollment provisions of Section 6401(a) of the Affordable Care Act.
Approval Date: April 26, 2012
Effective Date: January 1, 2012

Vermont
This SPA transmitted a proposed amendment to your approved Title XIX State plan to implement Section 6401(a) of the Affordable Care Act . This Affordable Care Act provision amended section 18660) of the Social Security Act to add a new paragraph ''(2) Provider Screening."
Approval Date: April 26, 2012
Effective Date: March 31, 2012

Vermont
This SPA amends the State's approved Title XIX State Plan to reduce the current Medicaid reimbursement methodology for limited distribution specialty pharmacies from average wholesale price (AWP) minus 14.2 percent to 16.5 percent, cover generic over-the-counter drugs when medically necessary without the option of prior authorization for brand name drugs and cover active pharmaceutical ingredient (API) drugs.
Approval Date: April 26, 2012
Effective Date: July 1, 2011

Pennsylvania
Removes Botulinum Toxins from the list of drugs requiring prior authorization.
Approval Date: April 26, 2012
Effective Date: February 13, 2012

Nevada
Updates provider screening and enrollment requirements.
Approval Date: April 26, 2012
Effective Date: April 1, 2012

Hawaii
Eliminates references to the Average Wholesale Price and defines how the Estimated Acquisition Cost is determined based on the lesser of the Wholesale Average Cost plus zero percent and increases the pharmacy dispensing fee from $4.67 to $5.00.
Approval Date: April 23, 2012
Effective Date: October 1, 2012
Topics: Financing & Reimbursement