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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 8471 - 8480 of 15820

West Virginia
This SPA implements Health Homes.
Approval Date: May 4, 2017
Effective Date: April 1, 2017
Topics: Benefits Eligibility Program Administration

Washington
This SPA amends the limitations on prescription drug coverage to clarify that agents when used for cosmetic purposes or hair growth will only be covered when the state has determined that use to be medically necessary.
Approval Date: May 4, 2017
Effective Date: January 1, 2017
Topics: Prescription Drugs Program Administration

Washington
This SPA clarified language regarding state and federal background checks, added some provider types, expanded the scope of certain training, and clarified information regarding assistive technology.
Approval Date: May 3, 2017
Effective Date: January 1, 2017
Topics: Financing & Reimbursement

Connecticut
This SPA provides for APM payments for dates of service from July 1, 2016 to June 30, 2017 to be equal to a clinic's standard medical Prospective Payment System (PPS) encounter rate plus an additional add-on payment per e-consult. Qualified FQHCs will bill e-consults separately from encounters using a modifier to track claim activity.
Approval Date: May 3, 2017
Effective Date: September 30, 2016
Topics: Program Administration

Connecticut
Under this SPA, outpatient hospital services are reimbursed using an ambulatory payment classification (APC) system based on Medicare's system but modified for Connecticut's Medicaid program.
Approval Date: May 3, 2017
Effective Date: July 1, 2016
Topics: Financing & Reimbursement

Connecticut
Updates the reimbursement methodology for autism spectrum disorder (ASD) services, allowing for a wider range of medically necessary ASD services to be reimbursed.
Approval Date: May 3, 2017
Effective Date: July 1, 2016
Topics: Financing & Reimbursement

Connecticut
Increases the fee for Healthcare Common Procedure Coding System HCPCS billinb code 17302 (Levonorgestrel-releasing intrauterine contractaceptive system.
Approval Date: May 3, 2017
Effective Date: February 1, 2015
Topics: Benefits Financing & Reimbursement Program Administration

Delaware
Expands coverage and allow reimbursement for chiropractors' services for all Medicaid eligible individuals.
Approval Date: May 3, 2017
Effective Date: January 1, 2017

Connecticut
Increases payment rates for private behavioral health clinics.
Approval Date: May 3, 2017
Effective Date: July 1, 2015
Topics: Financing & Reimbursement

Connecticut
Updates the Physician Radiology Fee Schedule by removing Current Procedural Terminology (CPT) codes: 77061 (Digital breast tomosynthesis; unilateral), 77062 (Digital breast tomosynthesis; bilateral) and 77063 (Screening digital breast tomosynthesis, bilateral).
Approval Date: May 3, 2017
Effective Date: February 4, 2015
Topics: Financing & Reimbursement Program Administration