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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 8491 - 8500 of 15820

Utah
Updates the utilization trend for the outpatient hospital upper payment limit in State Fiscal Year 2018.
Approval Date: May 1, 2017
Effective Date: July 1, 2017
Topics: Financing & Reimbursement

Connecticut
Incorporates 2015 Healthcare Common Procedure Coding System (HCPCS) changes (additions, deletions and description changes), with pricing of the codes, to the laboratory services fee schedule.
Approval Date: May 1, 2017
Effective Date: January 1, 2015
Topics: Financing & Reimbursement Program Administration

Connecticut
Enables medical clinics, rehabilitation clinics, and mental health and substance abuse clinics to be reimbursed for performing comprehensive diagnostic evaluations for autism spectrum disorder (ASD) for individuals under age twenty-one as described in the Attachment 3.1-A and 3.1-B pages with SPA 15-004.
Approval Date: May 1, 2017
Effective Date: January 1, 2015
Topics: Financing & Reimbursement

Connecticut
Adds coverage in the preventive services benefit category of the State Plan for medically necessary services to treat autism spectrum disorders (ASD) pursuant to the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services benefit for Medicaid members under age twenty-one. SPA 15-004 also establishes reimbursement for qualified providers to perform services to treat ASD pursuant to EPSDT for Medicaid members under age twenty-one.
Approval Date: May 1, 2017
Effective Date: January 1, 2015
Topics: Benefits Financing & Reimbursement

Connecticut
Incorporate the 2015 Healthcare Common Procedure Coding System (HCPCS) changes (additions, deletions and description changes), with pricing, to the following fee schedules: Physician, Psychologist, Independent Radiology, and Behavioral Health Clinician.
Approval Date: May 1, 2017
Effective Date: January 1, 2015
Topics: Program Administration

Ohio
Changes in reimbursement to nursing facilities for Medicaid services through an enhanced payment rate for nursing facilities that provide services to ventilator dependent individuals and that meet the criteria and conditions to participate in the department's alternative purchasing model for the provision of services to ventilator dependent individuals.
Approval Date: May 1, 2017
Effective Date: February 1, 2017
Topics: Financing & Reimbursement

South Carolina
This SPA proposes to remove any reference to drugs used for cosmetic purposes or hair growth from the state plan pages.
Approval Date: April 28, 2017
Effective Date: January 1, 2017
Topics: Prescription Drugs Program Administration

Tennessee
Incorporates a Health Home benefit (known as Health Links) into the state plan.
Approval Date: April 28, 2017
Effective Date: January 1, 2017
Topics: Benefits Program Administration

New Jersey
Adds a provision that limits rates from dropping below prior SFY rates and (2) Proposes an additional $650,000 to be allocated to special care nursing facilities for the period January 1, 2014 through June 30, 2014.
Approval Date: April 27, 2017
Effective Date: July 1, 2013
Topics: Financing & Reimbursement

Louisiana
Eliminate the total supplemental payments pool for graduate medical education payments to qualifying acute care hospitals.
Approval Date: April 27, 2017
Effective Date: March 1, 2017
Topics: Financing & Reimbursement