U.S. flag

An official website of the United States government

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 8081 - 8090 of 15886

Iowa
This amendment describe requirements that must be met for inpatient hospital claims to qualify for outlier payments.
Approval Date: October 27, 2017
Effective Date: July 1, 2017
Topics: Financing & Reimbursement Program Administration

Iowa
This SPA adjusted the Medicaid anesthesia conversion factor to be equal to the calendar year 2017 Medicare anesthesia conversion factor as adjusted for the state, & converted to a per minute amount & updated annually.
Approval Date: October 27, 2017
Effective Date: July 1, 2017

Alabama
This State plan amendment updates the Qualified Medicaid Practitioner Enhanced Payment and Average Commercial Rate Demonstration for a calendar year to set a Medicaid teaching physician rate based on a percentage of the Medicare rate.
Approval Date: October 26, 2017
Effective Date: September 1, 2017

Wyoming
This SPA will change State' s trauma code editing and reporting process with the implementation ofICD-10-CM and change the process of data exchange with the Wyoming Department of Transportation for Motor Vehicle Accident Reports.
Approval Date: October 26, 2017
Effective Date: October 1, 2017

Arkansas
This amendment was submitted in accordance with Section 214 of the Children's Health Insurance Program Reauthorization Act (CHIPRA), which permits States to cover certain children and pregnant women in both Medicaid and the Children's Health Insurance Program (CHIP) who are "lawfully residing in the United States" as described in section 1903(v)(4) and 2107(e)(l)(J) of the Social Security Act (the Act). Approval of this option resulted in a Federal budget impact of $1,546,729.00 for Federal Fiscal Year (FFY) 2018 and $4,891,174.00 for FFY 2019.
Approval Date: October 26, 2017
Effective Date: January 1, 2018
Topics: Benefits Financing & Reimbursement

Montana
The amendment will change the required composition of the Comprehensive Evaluation team for autism treatment services.
Approval Date: October 25, 2017
Effective Date: October 1, 2017

Montana
This amendment allows an exemption from establishing a Recovery Audit Contractor.
Approval Date: October 25, 2017
Effective Date: August 7, 2017
Topics: Financing & Reimbursement Program Administration

North Carolina
This SPA removes the prior authorization for procedures to align the State Plan with clinical policy.
Approval Date: October 25, 2017
Effective Date: August 1, 2017

Minnesota
Revises payment rates for substance use disorder services.
Approval Date: October 25, 2017
Effective Date: July 1, 2017

New Hampshire
Updates the state's Resource Utilization Group (RUG) reimbursement system to version IV and Minimum Data Set (MDS) 3.0 to be consistent with Medicare. Additionally, the state made a technical correction to the state plan language to clarify that the state budget adjustment factor is30o/o, which was previously undefined as part of the methodology.
Approval Date: October 24, 2017
Effective Date: October 24, 2017