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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 8721 - 8730 of 15828

California
This amendment allows for a one-time supplemental payment to service providers subject to the AB 97 Payment Reductions.
Approval Date: January 19, 2017
Effective Date: January 1, 2017
Topics: Financing & Reimbursement

North Carolina
This amendment originally proposed implementing a 1 percent rate reduction and rate freeze for subsequent years. After intensive collaboration with CMS, the State removed the 1 percent rate reduction and revised the SPA pages to clarify that this program will be reimbursed at lower of usual and customary charges or the North Carolina Medicaid fee schedule in effect at a given point in time.
Approval Date: January 19, 2017
Effective Date: January 1, 2015
Topics: Financing & Reimbursement Program Administration

Connecticut
This proposed SPA transmitted an amendment to the coverage and reimbursement sections of Connecticut' s approved Title XIX State plan to establish the PCMH + program. The PCMH+ program is being added as an Integrated Care Mode l within section I 905(a)(29) of the Social Security Act (Act). The PCM H+ program also involves shared savings payments and care coordination add-on payments for primary care case management services, as defined by section l 905(t) of the Act.
Approval Date: January 18, 2017
Effective Date: January 1, 2017
Topics: Financing & Reimbursement Program Administration

Oregon
Revises the reimbursement methods for the Targeted Case Management program for Self Sufficiency.
Approval Date: January 18, 2017
Effective Date: January 1, 2010
Topics: Financing & Reimbursement

New York
Continues to provide supplemental payments to certain non-state government nursing homes.
Approval Date: January 18, 2017
Effective Date: April 1, 2015
Topics: Financing & Reimbursement

Indiana
This SPA adds licensed clinical addiction counselors to the type of practitioner that can provide outpatient mental health services and receive reimbursement under the physicians'fee schedule reimbursement methodology.
Approval Date: January 18, 2017
Effective Date: November 1, 2016
Topics: Benefits Financing & Reimbursement

North Carolina
Amendment modifies the State's reimbursement methodology for setting payment rates for Psychiatric Residential Treatment Facility (PRTFs) services.
Approval Date: January 18, 2017
Effective Date: January 1, 2015
Topics: Financing & Reimbursement Program Administration

Kansas
This SPA added two new services under the Early and Periodic Screening Diagnosis and Treatment (EPSDT) section of the state plan.
Approval Date: January 18, 2017
Effective Date: January 1, 2017
Topics: Benefits Program Administration

Ohio
Payment for Services: Wheelchairs, parts, accessories, and related services.
Approval Date: January 18, 2017
Effective Date: January 1, 2017
Topics: Financing & Reimbursement

District of Columbia
This amendment delineates the process upon which the District will establish its Medicaid Asset Verification Program, inclusive of a plan for systems development and a process which verification will be established.
Approval Date: January 18, 2017
Effective Date: October 1, 2016
Topics: Program Administration