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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 8781 - 8790 of 15829

Pennsylvania
Using the Income Determination from another Means-Tested Public Benefit Programs to Support Medicaid Determinations." PA-16-0031 proposed to use the Supplemental Nutrition Assistance Program (SNAP), at initial application and renewal, and the LIHEAP program, at initial application, to support Medicaid income eligibility determinations under the Centers for Medicare and Medicaid Services' (CMS) guidance issued on August 31, 2015 (SHO #15-001).
Approval Date: December 21, 2016
Effective Date: August 1, 2017
Topics: Benefits Eligibility Financing & Reimbursement Program Administration

Oregon
This SPA renews Oregon's 1915(i) State Plan Home and Community-Based Services (HCBS) benefit for individuals with chronic mental illness.
Approval Date: December 21, 2016
Effective Date: January 1, 2017

Alabama
This SPA decreases the state's contingency fee rate for payments made to the Recovery Audit Contractor (RAC), and provides for an exception to 42 CFR 455.502(b), while it procures a new RAC vendor.
Approval Date: December 21, 2016
Effective Date: December 1, 2016
Topics: Financing & Reimbursement

Rhode Island
Out-patient hospital rate reduction.
Approval Date: December 21, 2016
Effective Date: January 1, 2016

Rhode Island
This SPA grants authority to implement a rate increase for outpatient hospital services.
Approval Date: December 21, 2016
Effective Date: July 1, 2016
Topics: Financing & Reimbursement

Minnesota
Removes the option for recovery of all medical assistance services from the estates of deceased individuals who received services at and after age 55, and limits recovery to nursing facility services, home and community-based services and associated hospital and prescription drug service.
Approval Date: December 20, 2016
Effective Date: July 1, 2016
Topics: Program Administration

Vermont
To increase reimbursement to primary care physicians by increasing the conversion factor used for primary care services payable under the RB RVS methodology.
Approval Date: December 20, 2016
Effective Date: October 1, 2016
Topics: Financing & Reimbursement

Montana
Updates the date of the fee schedule for the following State Plan services on the Introduction Page, effective January 1, 2017: Other Laboratory & X-Ray Services, Physicians' Services, Optometrists' Services, Physical Therapy Services, Occupational Therapy Services and Hearing Aids.
Approval Date: December 20, 2016
Effective Date: January 1, 2017
Topics: Program Administration

Missouri
This SPA was submitted for making the data conversion from the Medicaid Model Data Lab (MMDL) and to add additional chronic care conditions as qualifying conditions for community mental health centered health homes.
Approval Date: December 20, 2016
Effective Date: June 1, 2016
Topics: Program Administration

Oregon
Defines optometrists as "physicians" in the state of Oregon for Medicaid billing and services, which makes them eligible providers for the Electronic Health Record (EHR) Incentive Program.
Approval Date: December 19, 2016
Effective Date: July 1, 2016
Topics: Program Administration