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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 9251 - 9260 of 15783

Ohio
Health Homes Services Program Extension.
Approval Date: May 16, 2016
Effective Date: June 30, 2016
Topics: Program Administration

New Jersey
This SPA Implements Health Homes as authorized under Section 2703 of the Patient Protection and Affordable Care Act.
Approval Date: May 12, 2016
Effective Date: April 1, 2016
Topics: Benefits Program Administration

New Jersey
Children with SED will qualify for health home services whereas SED will be defined to include serious emotional disturbance, co-occurring developmental disability and mental illness, co-occurring mental health and substance abuse, or developmental Disability eligible (per NJ Statute 10:196) with symptomology of SED.
Approval Date: May 12, 2016
Effective Date: January 1, 2016
Topics: Benefits Eligibility Program Administration

Oregon
Amends the Alternative Benefit Plan to partially restore dental benefits for non-pregnant adults, restore coverage of dentures and crowns for adults and more frequently covered scaling and root planning for adults.
Approval Date: May 12, 2016
Effective Date: July 1, 2016
Topics: Benefits Dental Program Administration

Utah
Updates the hospice program to include the service intensity add-on payment as an available reimbursement in addition to the existing payment already outlined in the State Plan.
Approval Date: May 12, 2016
Effective Date: January 1, 2016
Topics: Financing & Reimbursement

Massachusetts
Updates the terms upon which the state intends to collect supplemental rebates from drug manufacturers in order to authorize the state, at its option, to also include MassHealth member utilization through its MassHealth MCOs under an agreement.
Approval Date: May 12, 2016
Effective Date: April 25, 2016
Topics: Program Administration

New Hampshire
Implements Section 2702 of the Affordable Care Act of 2010 and the implementing final rule at 42 CFR 447.
Approval Date: May 12, 2016
Effective Date: March 1, 2012
Topics: Program Administration

Mississippi
To implement discounts of claims with more than one significant procedure and compute a Mississippi Medicaid fee when a procedure's Ambulatory Payment Classification rate including all of its bundled services, is determined to be insufficient for the Mississippi Medicaid population effective June 1, 2015.
Approval Date: May 12, 2016
Effective Date: July 1, 2015
Topics: Financing & Reimbursement Program Administration

New York
This amendment proposes temporary rate adjustments under the Vital Access Provider program to specific providers for inpatient hospital services.
Approval Date: May 11, 2016
Effective Date: February 1, 2014
Topics: Financing & Reimbursement

New York
This amendment proposes temporary rate adjustments under the Vital Access Provider program to specific providers for inpatient hospital services.
Approval Date: May 11, 2016
Effective Date: November 1, 2014
Topics: Financing & Reimbursement