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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 8311 - 8320 of 15820

Washington
This SPA will allow charter schools and tribal schools to participate in the School Based Health Services (SBHS) Program.
Approval Date: June 29, 2017
Effective Date: April 1, 2017

Pennsylvania
Implements alternative payment methodologies (APM) for delivery services provided by Federally Qualified Health Center (FQHC) personnel in the acute care general hospital inpatient setting, and the payment by managed care organizations (MCO) to FQHCs and Rural Health Clinics (RHC) of rates that are not less than the Department of Human Services' Fee-for-Service provider specific Prospective Payment System (PPS) rate to RHCs and/or FQHCs that participate in the MCO network.
Approval Date: June 29, 2017
Effective Date: December 1, 2016
Topics: Financing & Reimbursement

New York
This SPA amends and updates the State's APG system for Outpatient Hospital Services.
Approval Date: June 29, 2017
Effective Date: July 1, 2014
Topics: Program Administration

Massachusetts
Changes to the reimbursement methodology for private psychiatric hospital and substance abuse hospital services.
Approval Date: June 29, 2017
Effective Date: October 1, 2016
Topics: Financing & Reimbursement

Massachusetts
Changes to the reimbursement methodology for private inpatient chronic disease and rehabilitation (CDR) hospital services. Specifically, it specifies rate year (RY) 2017 cost adjustment inflation factor of zero percent.
Approval Date: June 29, 2017
Effective Date: October 1, 2016
Topics: Financing & Reimbursement

Connecticut
To revise the dental fee schedule for children and adult services.
Approval Date: June 28, 2017
Effective Date: January 1, 2017
Topics: Dental Financing & Reimbursement

New York
Reinstates a trend factor, which will be applied to allowable operating costs, for psychiatric residential treatment facilities for children and youth (PRTFs).
Approval Date: June 28, 2017
Effective Date: January 1, 2015
Topics: Financing & Reimbursement

District of Columbia
This amendment will bring the District of Columbia into compliance with the reimbursement requirements of the Covered Outpatient Drug final rule with comment period (CMS-2345-FC) (81 FR 5170). Specifically, the District of Columbia proposes shifting from Estimated Acquisition Cost (EAC) to Actual Acquisition Cost (AAC) by using the National Average Drug Acquisition Cost (NADAC) plus a professional dispensing fee of $11.15. In addition, the SPA addresses coverage policies of covered outpatient drugs.
Approval Date: June 28, 2017
Effective Date: May 6, 2017

Iowa
This SPA proposes to bring Iowa into compliance with the actual acquisition cost reimbursement requirements in the Covered Outpatient Drug final rule with comment.
Approval Date: June 28, 2017
Effective Date: April 1, 2017

Iowa
Adjust premiums for persons who are eligible under the Medicaid for Employed Persons with Disabilities (MEPD) group. These Premiums are adjusted as often as annually according to state law which ties the maximum premium to the average state employee's health insurance premium.
Approval Date: June 28, 2017
Effective Date: August 1, 2017
Topics: Financing & Reimbursement