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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 9631 - 9640 of 15783

Arkansas
Changes the contact name for the state Medicaid Program Integrity to Medicaid Inspector General.
Approval Date: December 7, 2015
Effective Date: January 1, 2016
Topics: Program Administration

California
This SPA adds Mendocino and Trinity counties to the list of geographic areas offering Targeted Case Management (TCM) services for the "Individuals in Jeopardy of Negative Health or Psycho - Social Outcomes " TCM group.
Approval Date: December 7, 2015
Effective Date: July 1, 2015
Topics: Program Administration

North Dakota
This amendment provides the terms upon which the state will collect supplemental rebates from drug manufacturers.
Approval Date: December 4, 2015
Effective Date: July 1, 2015
Topics: Financing & Reimbursement

Minnesota
Expands access to medication therapy management services and allows physician assistants to provide medication management services in outpatient setting.
Approval Date: December 4, 2015
Effective Date: July 1, 2015
Topics: Prescription Drugs Program Administration

West Virginia
Adds provisions of Medicaid coverage to Pregnant Women, Children Under Age 19, Parents/ Caretaker Relatives, Adult Group, and Former Foster Children when determined presumptively eligible by a qualified entity.
Approval Date: December 4, 2015
Effective Date: July 1, 2015
Topics: Benefits Program Administration

Kansas
Describes the Modified Adjusted Gross Income (MAGI)-based hospital presumptive eligibility criteria covered under Iowa's Medicaid State Plan.
Approval Date: December 4, 2015
Effective Date: January 1, 2014
Topics: Financing & Reimbursement Program Administration

Maine
To update the pharmacy coverage section of the state plan to align with requirements of Section 175 of the Medicare Improvement for Patients and Providers Act of 2008.
Approval Date: December 4, 2015
Effective Date: April 1, 2013
Topics: Prescription Drugs Program Administration

Montana
Reimbursement update for TCM for Children and Youth with Special Health Care Needs.
Approval Date: December 4, 2015
Effective Date: July 1, 2008
Topics: Financing & Reimbursement

Rhode Island
Eliminates the October 1, 2015 rate increases and implements a 2% rate cut for nursing facility services.
Approval Date: December 4, 2015
Effective Date: August 1, 2015
Topics: Financing & Reimbursement

Montana
Updates reimbursement through a provider rate increase, and provide updated reimbursement for add-on payments for Direct Care Wages and Health Insurance for Health Care Workers.
Approval Date: December 3, 2015
Effective Date: July 1, 2015
Topics: Financing & Reimbursement