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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 8101 - 8110 of 15820

Connecticut
This SPA amends reimbursement for items of durable medical equipment ( DME), including increasing fees for certain items; restructuring soft limits for items which require prior authorization (PA); discontinuing certain codes for lac k of utilization; setting a cap on repairs for certain orthotics and prosthetics which can be waived with prior authorization; and reduction in payment for certain items to reflect level of reimbursement of neighboring states.
Approval Date: September 26, 2017
Effective Date: March 1, 2017
Topics: Financing & Reimbursement

Ohio
This SPA proposes to bring Ohio into compliance with the reimbursement requirements in the Covered Outpatient Drug final rule with comment period (CMS-2345-FC).
Approval Date: September 26, 2017
Effective Date: April 1, 2017

New York
Continues for the period April 1, 2017 through March 31, 2019, various previously enacted cost containment measures identified in the SPA's language.
Approval Date: September 25, 2017
Effective Date: April 1, 2017
Topics: Program Administration

Pennsylvania
Pennsylvania Medicaid State Plan Eligibility - Former Foster Care Youth from a Different State.
Approval Date: September 25, 2017
Effective Date: October 1, 2017
Topics: Benefits Eligibility Program Administration

New Hampshire
Health fnsurance Premium Payment (HIPP) Cost.
Approval Date: September 22, 2017
Effective Date: April 1, 2017
Topics: Financing & Reimbursement Program Administration

Louisiana
This SPA proposes to bring Louisiana into compliance with the reimbursement requirements in the Covered Outpatient Drug final rule with comment period (CMS-2345-FC), such as the provisions in 42 CFR 447.518(a).
Approval Date: September 22, 2017
Effective Date: April 20, 2017

Texas
This amendment is to bring the state plan into compliance with the applicable requirements of 42 Code of Federal Regulations (CFR) §447.518, relating to payment for covered outpatient drugs, specifically as it relates to addressing reimbursement methodology for 340B drugs, physician administered drugs, clotting factor, federal supply schedule and drugs purchased at nominal price.
Approval Date: September 22, 2017
Effective Date: April 1, 2017

Florida
This SPA proposes to bring Florida into compliance with the reimbursement requirements in the Covered Outpatient Drug final rule with comment period (CMS-2345-FC).
Approval Date: September 22, 2017
Effective Date: April 1, 2017

Colorado
Reimbursement update for Fee Schedule Rate Increases.
Approval Date: September 21, 2017
Effective Date: July 1, 2017
Topics: Financing & Reimbursement

Colorado
This Amendment would decrease reimbursement rates for evaluation and management ( E& M) and vaccine administration services, returning the reimbursement for affected services to December 2012 rates.
Approval Date: September 21, 2017
Effective Date: July 1, 2016
Topics: Financing & Reimbursement