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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 8621 - 8630 of 15826

Nevada
Adds reimbursement methodology language for telehealth services and adds a payment methodologyfor select critical access hospitals.
Approval Date: March 16, 2017
Effective Date: November 24, 2016
Topics: Financing & Reimbursement

Arkansas
Changes to the basis for ingredient cost reimbursement to comply with requirements of the Covered Outpatient Drug Final Rule with comment (CMS-2345-FC) (81 FR 5170) pertaining to drug reimbursement in the Medicaid program.
Approval Date: March 16, 2017
Effective Date: April 1, 2017

Michigan
Health Homes Technical corrections.
Approval Date: March 15, 2017
Effective Date: October 1, 2016
Topics: Program Administration

Michigan
Guardianship Fee Update.
Approval Date: March 15, 2017
Effective Date: December 1, 2016
Topics: Financing & Reimbursement

Hawaii
This SPA eliminates restrictions to telehealth services that were previously included in Hawaii's approved Medicaid State Plan.
Approval Date: March 15, 2017
Effective Date: January 1, 2017
Topics: Program Administration

Wisconsin
Medication Therapy Management.
Approval Date: March 15, 2017
Effective Date: April 1, 2017
Topics: Benefits Prescription Drugs

New Hampshire
"Substance Use Disorder Treatment and recovery support Services" allows for the availability of SUD services for all individuals eligible for Medicaid.
Approval Date: March 14, 2017
Effective Date: July 1, 2016

Wisconsin
Medicaid services provided through managed care organizations, payments under nonrisk contracts.
Approval Date: March 13, 2017
Effective Date: October 1, 2016
Topics: Financing & Reimbursement Program Administration

South Carolina
This SPA allows the exclusion of particular covered outpatient drugs, or class of drugs, from the managed care organization (MCO) model in those cases where they are not included in the MCO capitated rate.
Approval Date: March 13, 2017
Effective Date: October 1, 2016
Topics: Program Administration

Maryland
This SPA creates a new bundled daily rate for Community First Choice providers delivering more than 12 hours daily to participants as directed by their plan of service.
Approval Date: March 13, 2017
Effective Date: April 1, 2017
Topics: Financing & Reimbursement