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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 9701 - 9710 of 15783

Nebraska
Proposed to use 51 percent of the Federal Poverty Level (FPL) for the Modified Adjusted Gross Income (MAGI) standard for individuals eligible through the reasonable classification groups under 42 CFR 435.222 rather than the fixed dollar standards previously used. This is the same percentage used by the federally facilitated marketplace when assessing Medicaid eligibility for this group. Use of the FPL percentage income test will provide a more seamless coordination with the health care marketplace and reduce the administrative complexity of making eligibility determinations.
Approval Date: November 10, 2015
Effective Date: November 1, 2015
Topics: Eligibility Financing & Reimbursement

Nebraska
Proposed to convert the July 16th, 1996, AFDC payment standard amount to a percentage of the federal poverty level (23%) for children in the reasonable classification group for qualified youth age 19 to 21 who entered into a subsidized guardianship or adoption at age 16 or older.
Approval Date: November 10, 2015
Effective Date: November 1, 2015
Topics: Financing & Reimbursement

Nebraska
Eliminates the requirements that the dependent child must be deprived of parental support or care as a requirement of eligiblity for the Parent/Caretaker Relative group; to use 58% of the FPL as the income limit for this group rather then the fixed dollar amounts previously used.
Approval Date: November 10, 2015
Effective Date: November 1, 2015
Topics: Financing & Reimbursement Program Administration

Washington
Updatess the effective dates of the fee schedules for alcohol and drug treatment and detoxification services.
Approval Date: November 10, 2015
Effective Date: July 2, 2015
Topics: Financing & Reimbursement

District of Columbia
This amendment will enable the District to amend the methodology for establishing the penalty period for asset transfers by individuals receiving Medicaid-reimbursable intuitional care in nursing facilities.
Approval Date: November 10, 2015
Effective Date: January 1, 2016

South Carolina
This SPA is to limit allowable pre-eligibility medical expenses applied to reduce recurring income for long term care services to expenses incurred in the three months prior to the month of the Medicaid application.
Approval Date: November 10, 2015
Effective Date: October 1, 2015

Washington
Updated the effective dates of the fee schedules for several Medicaid services, including; All other practitioners and Targeted Case Management for infants and parents.
Approval Date: November 9, 2015
Effective Date: August 6, 2015
Topics: Financing & Reimbursement

Tennessee
The state proposes to change the dispensing fee for compounded prescriptions to a tiered rate based on the pharmacist's reported level of effort.
Approval Date: November 6, 2015
Effective Date: July 1, 2015

Louisiana
Terminates the Louisiana Health Insurance Premium Payment (LaHIPP) Program Due to a Budget Deficit in State Fiscal Year 2015-2016.
Approval Date: November 5, 2015
Effective Date: December 1, 2015
Topics: Financing & Reimbursement

Colorado
Shows Methods and Standards for Establishing Payment Rates for Family Planning Services, Reflecting Rate Increases.
Approval Date: November 5, 2015
Effective Date: September 26, 2015
Topics: Financing & Reimbursement