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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 8701 - 8710 of 15828

Texas
Revises Texas pharmacy reimbursement methodology for the Medicaid fee-for-service program from the current methodology to one that pays pharmacies based on the drug ingredient cost, defined as the acquisition cost (AC), plus a professional dispensing fee.
Approval Date: February 6, 2017
Effective Date: June 1, 2016

Alabama
This state plan amendment resumes enhanced payments through the Alabama Medicaid Physician's Primary Care Enhanced Rates "Bump" Program for dates of service on or after October 1, 2016.
Approval Date: January 31, 2017
Effective Date: October 1, 2016
Topics: Financing & Reimbursement

New York
This amendment creates a new nursing home specialty rate for the neurodegenerative disease population, which includes only those patients diagnosed with Huntington's disease and Amyotrophic Lateral Sclerosis.
Approval Date: January 30, 2017
Effective Date: November 1, 2016
Topics: Financing & Reimbursement

Arizona
This SPA updates the State Plan section on ground ambulance rates.
Approval Date: January 30, 2017
Effective Date: October 1, 2015
Topics: Financing & Reimbursement

Connecticut
This SPA is an amendment to Connecticut' s approved Title XIX Medicaid State plan to renew the home and community-based services benefit under Section 1915 (i ) of the Social Security Act for individuals 65 and older who meet the needs-based and financial eligibility criteria in the approved SPA.
Approval Date: January 27, 2017
Effective Date: February 1, 2017
Topics: Benefits Eligibility Program Administration

Michigan
Updates case management language per companion letter dated May 9, 2016 for SPA 16-0008.
Approval Date: January 24, 2017
Effective Date: October 1, 2016
Topics: Program Administration

Maine
Revises reimbursement for nursing facility services.
Approval Date: January 23, 2017
Effective Date: August 13, 2015
Topics: Financing & Reimbursement

South Carolina
Adds the optional Medicaid eligibility group which provides coverage to women and men that is limited to family planning and family planning related services under the state plan (template S59).
Approval Date: January 20, 2017
Effective Date: February 1, 2017

Florida
Purpose to update reimbursement rates for county health departments (CHD) and includes technical and editorial changes, deletes obsolete language, and provides CHDs to buy-back any rate reduction not to exceed cost.
Approval Date: January 20, 2017
Effective Date: July 1, 2016
Topics: Financing & Reimbursement Program Administration

Texas
This amendment was submitted to reduce payment rates for physical, occupational, and speech therapy services.
Approval Date: January 19, 2017
Effective Date: December 15, 2016
Topics: Financing & Reimbursement