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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 8151 - 8160 of 15820

South Carolina
This amendment adds Autism Spectrum Disorder (ASD) services to medically eligible beneficiaries' ages 0-21 to the State Plan.
Approval Date: September 7, 2017
Effective Date: July 1, 2017

Oregon
This SPA removes the exclusion that currently exists for hippo-therapy.
Approval Date: September 7, 2017
Effective Date: October 1, 2017
Topics: Benefits Program Administration

North Carolina
The state plan proposes revisions to the reimbursement methodology for physician administered contraceptives at Wholesale Acquisition Cost (WAC) plus 6% and physician administered vaccines (as noted on the medical pages) at WAC plus 3%, while all other physician administered drugs will remain at prices established on January 1, 2015.
Approval Date: September 7, 2017
Effective Date: July 1, 2017
Topics: Financing & Reimbursement

Louisiana
This state plan amendment proposes to reinstate the Louisiana Health Insurance Premium Payment (LAHIPP) program in order to reduce Medicaid costs by establishing or maintaining a third party resource as the primary payer of the Medicaid recipient's medical expenses.
Approval Date: September 6, 2017
Effective Date: April 20, 2017
Topics: Financing & Reimbursement

Guam
Revises Guam's on-island inpatient hospital and outpatient hospital rate.
Approval Date: September 6, 2017
Effective Date: June 3, 2017
Topics: Financing & Reimbursement

North Carolina
The companion letter requested the state to clearly define and describe rehabilitation services and to identify the requirements for practitioner providers.
Approval Date: September 6, 2017
Effective Date: September 25, 2013
Topics: Program Administration

Virginia
To include the terms upon which the state will collect supplemental rebates from drug manufacturers on those drugs dispensed to Medicaid Managed Care Organizations (MCO) enrollees.
Approval Date: September 6, 2017
Effective Date: July 1, 2017
Topics: Managed Care Program Administration

Colorado
This amendment updates the reimbursement methodology for supplemental Medicaid inpatient hospital payments and Disproportionate Share Hospital payments.
Approval Date: September 5, 2017
Effective Date: October 26, 2016
Topics: Financing & Reimbursement Program Administration

Washington
This SPA removes the requirement for prior authorization for hospice services, consistent with federal policy and state law.
Approval Date: September 5, 2017
Effective Date: July 1, 2017
Topics: Program Administration

North Dakota
This amendment will implement a rate increase for ambulance services.
Approval Date: September 5, 2017
Effective Date: July 1, 2017
Topics: Financing & Reimbursement