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 8381 - 8390 of 15820

Nevada
Updates Attachment 4.19-B to reflect changes to the reimbursement methodologies for multiple out-patient services.
Approval Date: June 1, 2017
Effective Date: January 1, 2017
Topics: Financing & Reimbursement

Ohio
Coverage & Limitations and Payment for Services Patient-Centered Medical Homes.
Approval Date: June 1, 2017
Effective Date: January 1, 2017
Topics: Financing & Reimbursement

Louisiana
Reduces the amount of the disproportionate share hospital (DSH) payments pool for federally mandated statutory hospitals from $1,000,000 to $1,000.
Approval Date: May 31, 2017
Effective Date: March 1, 2017
Topics: Financing & Reimbursement

Nevada
Changes the reimbursement methodology for Durable Medical Supplies, Prosthetics, Orthotics, and Supplies (DMEPOS).
Approval Date: May 31, 2017
Effective Date: January 1, 2017
Topics: Financing & Reimbursement

Alaska
This SPA removes the requirement that functional assessments be conducted in a consumer's home and also provides clarification on the two programs of Personal Care Services (agency-based and consumer- directed), and the provider qualifications for each.
Approval Date: May 30, 2017
Effective Date: January 1, 2017
Topics: Program Administration

Minnesota
Revises payment rates for providers specializing in the treatment of cerebral palsy, spina bifida, epilepsy, closed head injuries, and orthopedic conditions.
Approval Date: May 26, 2017
Effective Date: July 1, 2015
Topics: Financing & Reimbursement

Maryland
This SPA updates Maryland's State Plan to update covered outpatient drugs to include agents when used for cosmetic purposes or hair growth when medically necessary.
Approval Date: May 26, 2017
Effective Date: January 1, 2017
Topics: Program Administration

Wyoming
The Tribal Leadership Advisory Council was established through an internal Wyoming Department of Health policy to seek advice on a regular, ongoing basis from the federally recognized Wyoming Tribes and Indian Health Services on matters related to Medicaid and/ or Kid Care CHIP. The wording for this policy was added to the Tribal Consultation SPA.
Approval Date: May 26, 2017
Effective Date: April 1, 2017

Nevada
Adds a new payment methodology for services provided in an ambulatory surgery setting.
Approval Date: May 26, 2017
Effective Date: January 1, 2017
Topics: Financing & Reimbursement

Kansas
This amendment provides for a 4.00% reduction in provider payments for all services. Exceptions to the 4.00% reductions include Home and Community Based, Rural Health Clinic, Federally Qualified Health Center' s, Pharmacy, Limited Hospice, PACE, and Indian Health services.
Approval Date: May 26, 2017
Effective Date: July 1, 2016
Topics: Financing & Reimbursement