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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 9551 - 9560 of 15783

Montana
Incorporates the MAGI-Based Adult Group and Parents and Other CareTaker Relatives Into Montana Medicaid State's Plan in Accordance with the Affordable Care Act.
Approval Date: January 7, 2016
Effective Date: January 1, 2016

Maryland
Reflects Changes Necessary to Convert the Community First Choice Program to An Agency-Only Model.
Approval Date: January 7, 2016
Effective Date: October 1, 2015

California
To provide technical updates for prosthetic and orthotic appliances and hearing aids to reflect that these appliances are covered when prescribed by a physician or other licensed practitioner, instead of physician or podiatrist.
Approval Date: January 7, 2016
Effective Date: October 1, 2015
Topics: Program Administration

North Carolina
Proposes that the state use an average acquisition cost (AAC) reimbursement methodology to reimburse brand and generic drug ingredient costs.
Approval Date: January 7, 2016
Effective Date: January 1, 2016

Illinois
Makes Comprehensive Revisions to Large Sections of the Inpatient and Outpatient Service Definition and Reimbursement Sections of the State Plan.
Approval Date: January 6, 2016
Effective Date: July 1, 2014

Illinois
SNF/Ped Facilities that Serve Exceptional Care Patients and Have 30% or More of Their Patients Receiving Ventilator Care Shall Receive An Additional Payment of $165.52 Per Day for Ventilator Care.
Approval Date: January 6, 2016
Effective Date: January 11, 2014

Louisiana
Amends the provisions governing therapeutic group homes in order to: revise the terminology to be consistent with current program operations and revises the reimbursement methodology to establish capitation payments to managed care organizations for children's services.
Approval Date: January 6, 2016
Effective Date: December 1, 2015
Topics: Financing & Reimbursement Program Administration

Ohio
Payment for services: Provider-administered pharmaceuticals.
Approval Date: January 6, 2016
Effective Date: November 1, 2015
Topics: Financing & Reimbursement

Louisiana
Changes the provisions governing school based health services in order to transition these services out of managed care and into the group of school based Medicaid services provided by Local Education Agencies.
Approval Date: January 5, 2016
Effective Date: December 1, 2015
Topics: Program Administration

Illinois
Reduces the dispensing fee from $2.40 to $1.40 for single source drugs, $4.50 to $3.50 for multiple source drugs and $12.00 to $11.00 for 340B purchased eingle source and multiple source drugs.
Approval Date: January 5, 2016
Effective Date: May 1, 2015
Topics: Financing & Reimbursement