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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 8871 - 8880 of 15830

Vermont
Updates the reimbursement methodology for outpatient hospital services to remove separate billing for revenue codes 510-519 (clinic services), and to make a corresponding adjustment upward in the percentage of the OPPS rates that VT will pay to participating hospitals.
Approval Date: November 21, 2016
Effective Date: July 1, 2016
Topics: Financing & Reimbursement

Virginia
Adds requirements for accepting, managing, and completing requests for community-based and nursing facilities and using the electronic Preadmission Screening System.
Approval Date: November 21, 2016
Effective Date: September 1, 2016
Topics: Program Administration

Michigan
Cost Sharing - HMP Copay Increases.
Approval Date: November 18, 2016
Effective Date: April 1, 2017
Topics: Cost Sharing Financing & Reimbursement

New York
To continue the trend factor to an amount no greater then zero for nursing facility for services provided on and after April 23, 2013 through March 31, 2017.
Approval Date: November 18, 2016
Effective Date: April 23, 2015
Topics: Financing & Reimbursement Program Administration

Massachusetts
To provide premium assistance for student health insurance offered in the individual market.
Approval Date: November 18, 2016
Effective Date: June 1, 2016
Topics: Benefits Program Administration

Ohio
Amends payment for services for State Fiscal Year 2017 rate setting for ICF/UD services.
Approval Date: November 18, 2016
Effective Date: July 1, 2016
Topics: Financing & Reimbursement

Nebraska
Limitations-Prescribed Drugs.
Approval Date: November 17, 2016
Effective Date: January 1, 2017
Topics: Financing & Reimbursement Prescription Drugs

North Dakota
Updates the DRG APR grouper to version 32.
Approval Date: November 17, 2016
Effective Date: July 1, 2016
Topics: Program Administration

North Dakota
Provides for updates to the supplemental payments for Intermediate Care Facilities ICFs) for State Fiscal Year( SFY) 2017.
Approval Date: November 17, 2016
Effective Date: July 1, 2016
Topics: Financing & Reimbursement

North Carolina
Modifies the State's reimbursement methodology for setting payment rates for nursing facility services.
Approval Date: November 17, 2016
Effective Date: October 1, 2016
Topics: Financing & Reimbursement