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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 13261 - 13270 of 15693

Oregon
HSPA Health Homes.
Approval Date: March 13, 2012
Effective Date: October 1, 2011

Pennsylvania
This SPA proposes to change the requirement for prior authorization of an early refill from 25 percent of the same earlier-dispensed medication to 15 percent.
Approval Date: March 13, 2012
Effective Date: September 19, 2011

Oregon
This SPA was submitted to reflect specified provider rate reductions as required based upon Oregon's 2011-13 legislatively approved budget.
Approval Date: March 9, 2012
Effective Date: August 1, 2011
Topics: Financing & Reimbursement

Indiana
This amendment proposes implementation of lead case management and enviromental lead investigation services for individuals who tested for elevated blood lead levels.
Approval Date: March 9, 2012
Effective Date: June 18, 2009
Topics: Program Administration

Arizona
Updates the State Plan to include standards of pricing and payment for 340B drugs.
Approval Date: March 9, 2012
Effective Date: February 1, 2012
Topics: Financing & Reimbursement Prescription Drugs

Ohio
Targeted Case Management services provided to Medicaid-eligible expectant first time parents, first time parents, infants, and toddlers under the age of three years who are enrolled and participating in Ohios Help Me Grow Home Visiting Program.
Approval Date: March 9, 2012
Effective Date: July 1, 2012

South Carolina
This SPA proposes to revise the payment methodology for Nursing Facility services. Specifically, this amendment proposes to replace the intensive Technical Services reimbursement program with the Complex care reimbursement program and update the payment rate for this program.
Approval Date: March 8, 2012
Effective Date: October 1, 2011
Topics: Financing & Reimbursement

Indiana
This amendment seeks to revise the reimbursement methodology of DM Medical Equipment and Hearing Aids as well as reduce the rates by 5% for services rendered between July 1, 2011 and June 30, 2011.
Approval Date: March 8, 2012
Effective Date: July 1, 2011

Ohio
Modification of the UPL gap calculation for outpatient hospital services.
Approval Date: March 8, 2012
Effective Date: July 1, 2011

South Dakota
Provides Coverage for services in Freestanding Birth Centers.
Approval Date: March 6, 2012
Effective Date: March 1, 2012