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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 8081 - 8090 of 15820

Texas
This plan amendment revises the State Plan for NEMT services to address changes in two regions of the state.
Approval Date: October 3, 2017
Effective Date: September 1, 2017
Topics: Program Administration

Texas
This plan amendment replaces the requirement that Medicaid managed care organizations (MCOs) reimburse Federally Qualified Health Centers (FQHCs) their full per-visit rate with a requirement that in the event that an MCO or dental maintenance organization pays less than the FQHC's full per-visit rate, the State will ensure the remainder is paid on at least a quarterly basis.
Approval Date: October 3, 2017
Effective Date: September 1, 2017
Topics: Financing & Reimbursement Program Administration

Washington
This SPA removes pre-authorization for Voluntary Inpatient Psychiatric Service FFS.
Approval Date: October 3, 2017
Effective Date: July 4, 2017
Topics: Financing & Reimbursement Program Administration

New Jersey
The SPA reflects the increased case management organizations monthly rate that was approved as part of NJ's State Fiscal Year 2018 Appropriations Act.
Approval Date: October 3, 2017
Effective Date: August 1, 2017
Topics: Financing & Reimbursement

Washington
This amendment updated the effective date of the conversion factors used to set payment rates for several Medicaid programs.
Approval Date: October 2, 2017
Effective Date: July 1, 2017
Topics: Financing & Reimbursement

Oregon
Requests an exemption pursuant to 42 CFR 455.508(f) to the regulation requiring the states Recovery Audit Contractors (RAC) not review claims older than 3 years, as well as correct theSection number.
Approval Date: October 2, 2017
Effective Date: October 1, 2017
Topics: Program Administration

Wisconsin
This amendment revises reimbursement methodologies for inpatient hospital rates and methodologies for Disproportionate Share Hospital (DSH) payments.
Approval Date: October 2, 2017
Effective Date: October 1, 2016
Topics: Financing & Reimbursement Program Administration

Florida
This SPA allows the agency to cover Medicaid-enrolled private and charter schools for services rendered in a school setting for children under the age of 21 years.
Approval Date: October 2, 2017
Effective Date: October 28, 2016

Connecticut
Adds procedure codes GO 151, GO 152 and GO 153 to the home health fee schedule.
Approval Date: October 1, 2017
Effective Date: September 13, 2017
Topics: Financing & Reimbursement Program Administration

New York
This amendment proposes additional supplemental payments to private hospitals for inpatient services through March 31. 2018.
Approval Date: September 29, 2017
Effective Date: April 1, 2017
Topics: Financing & Reimbursement