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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 13181 - 13190 of 15693

New York
Health Home Services.
Approval Date: April 10, 2012
Effective Date: July 1, 2012

Indiana
This amendment imposes a 5% rate reduction on all medical supplies provided from July 1, 2011 to June 30, 2013. This SPA also seeks to change the methodology of Medical Supply reimbursement to utilize Medicare rates as the reimbursed amount when available, or the acquisition cost when Medicare rates are not available.
Approval Date: April 9, 2012
Effective Date: July 1, 2011
Topics: Financing & Reimbursement Program Administration

Nevada
Provide Nursing Facilities with monthly supplemental payments.
Approval Date: April 6, 2012
Effective Date: October 1, 2011

Guam
Non-Payment for Health Care-Acquired Conditions and Provider-Preventable Conditions.
Approval Date: April 6, 2012
Effective Date: October 1, 2011

Tennessee
This SPA revise the payment methodology for inpatient and outpatient hospital services and other outpatient services for surgical procedures. Specifically, the amendment proposes to deny payment for Provider Preventable conditions (PPC).
Approval Date: April 6, 2012
Effective Date: October 1, 2011

New York
CHHA Episodic Pricing.
Approval Date: April 4, 2012
Effective Date: May 1, 2012
Topics: Program Administration

North Carolina
This State Plan revise the scope and nature of the personal care service (PCS) benefit under the North Carolina State Plan.
Approval Date: April 4, 2012
Effective Date: May 1, 2012

South Dakota
This State Plan Amendment clarifies nonp-ayment for health Care-a nd hospital -a cquired conditions (HAGS).
Approval Date: April 3, 2012
Effective Date: July 1, 2012
Topics: Program Administration

Pennsylvania
This amendment modifies the State's methods for making outlier payments to acute care general hospitals.
Approval Date: April 3, 2012
Effective Date: July 1, 2011
Topics: Program Administration

Delaware
This SPA modifies qualification criteria for Disproportionate Share Hospitals and their reimbursement methodology.
Approval Date: April 3, 2012
Effective Date: May 1, 2012
Topics: Financing & Reimbursement