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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 9171 - 9180 of 15783

Idaho
Modifies Idaho's Healthy Connections Primary Care Case Management Program by creating a new tier-based case management fee structure with four distinct payment tiers that vary in amount and increase by tier based upon qualifying criteria.
Approval Date: June 21, 2016
Effective Date: February 1, 2016
Topics: Program Administration

Utah
Updates the effective date of chiropractic service rates to July 1, 2016.
Approval Date: June 21, 2016
Effective Date: July 1, 2016
Topics: Financing & Reimbursement

Utah
Updates the effective date of audiology rates to July 1, 2016.
Approval Date: June 21, 2016
Effective Date: July 1, 2016
Topics: Financing & Reimbursement

Minnesota
Expands coverage of Medicaid services provided via telemedicine.
Approval Date: June 21, 2016
Effective Date: January 1, 2016
Topics: Benefits Program Administration

Iowa
This change will bring the state plan into conformity with the State's approved 1915(b) waiver, which outlines disenrollment rights. Enrollees can disenroll within the first 90 days of enrollment with an MCO, after the first 90 days.
Approval Date: June 21, 2016
Effective Date: April 1, 2016

Nevada
Adds a reimbursement methodology for coma procurement.
Approval Date: June 21, 2016
Effective Date: April 1, 2016
Topics: Financing & Reimbursement Program Administration

California
Is an annual upate to the DDRG parameters, which includes updating the wage area neutrality adjustment, setting the labor share percentage for hospitals with a wage area index equal to or less than 1.00 to 62% and updating the Remote Rural and Statewide DRG BAse Price, Outlier Thresholds and Outlier Percentage Upper Bound, Discharge Status Values, and the DRG and HAC Grouper versions.
Approval Date: June 21, 2016
Effective Date: July 1, 2016
Topics: Financing & Reimbursement Program Administration

Minnesota
Clarifies the maximum amount to be paid for Medicare Part B coinsurance and deductibles for services provided by rural health clinics and federally qualified health centers.
Approval Date: June 21, 2016
Effective Date: January 1, 2016
Topics: Financing & Reimbursement Program Administration

Idaho
This SPA ends the Health Home program authorized and Section 2703 of the Patient Protection and Affordable Care Act.
Approval Date: June 20, 2016
Effective Date: February 1, 2016
Topics: Program Administration

Utah
Updates the effective date of speech pathology rates to July 1, 2016.
Approval Date: June 20, 2016
Effective Date: July 1, 2016
Topics: Financing & Reimbursement