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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 6991 - 7000 of 15806

Connecticut
Revise the Federally Qualified Health Clinic (FQHC) reimbursement provisions to add an alternative payment methodology for Indian Health Services (I.H.S.) tribal clinics, pursuant to Section 1902(bb)(6) of the Social Security Act.
Approval Date: November 26, 2018
Effective Date: July 1, 2017
Topics: Financing & Reimbursement

Illinois
Healthcare and Family Services (IHFS) will not implement a single preferred drug list. IHFS will remove references to single PDL from the Supplemental Rebate Agreement.
Approval Date: November 26, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement

California
Will add pharmacists under the "Other Licensed Practitioner" provider category so that Medi-Cal may reimburse these providers for services for already-covered medications.
Approval Date: November 26, 2018
Effective Date: April 1, 2019
Topics: Financing & Reimbursement

Kansas
Received Kansas' State Plan Amendment (SP A) transmittal# 18-0011, which documents the payment methodology for Reserve Days at Psychiatric Residential Treatment Facilities (PRTFs).
Approval Date: November 23, 2018
Effective Date: July 1, 2018
Topics: Program Administration

Iowa
The purpose of the SPA is to implement a statewide fee schedule reimbursement for case management services in accordance with 2018 Iowa Acts, Senate File 2418, Section 132.
Approval Date: November 23, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement

Iowa
Pharmacy co-payment to $1. 00 per prescription or refill.
Approval Date: November 22, 2018
Effective Date: December 1, 2018
Topics: Financing & Reimbursement

Mississippi
Allow the Mississippi Division of Medicaid to include Psychiatric Residential Treatment Facility (PRTF) services as covered and reimbursed by the coordinated Care organizations (CCOs).
Approval Date: November 21, 2018
Effective Date: October 1, 2018
Topics: Financing & Reimbursement

Missouri
Provides annual assurance of the pharmacy program adherence to the requirements of the Federal Upper Limits (FUL).
Approval Date: November 21, 2018
Effective Date: October 1, 2017
Topics: Prescription Drugs Program Administration

Ohio
Inpatient Hospital Services Reimbursement Methodology.
Approval Date: November 21, 2018
Effective Date: September 1, 2018
Topics: Financing & Reimbursement

Ohio
Intermediate Care Facilities-Individuals with Intellectual Disabilities (ICF-IID) Payment Methodology Restructure.
Approval Date: November 21, 2018
Effective Date: July 1, 2018
Topics: Financing & Reimbursement