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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 9731 - 9740 of 15783

Illinois
Allows payment to providers for copayments and deductibles of Qualified Medicare Beneficiaries enrolled in Medicare Advantage plans.
Approval Date: October 29, 2015
Effective Date: July 1, 2015
Topics: Financing & Reimbursement

Texas
Adjusts the payment rates for the Day Activities and Health Services program to be equal to the payment rates in effect on August 31, 2015 plus an additional $0.06 increase to the base rate.
Approval Date: October 29, 2015
Effective Date: September 1, 2015
Topics: Financing & Reimbursement

California
Modifies the cost report used for the Drug Medi-Cal Program and ensures the state-developed cost report is in a format that meets CMS's reimbursement requirements for cost-based methodology.
Approval Date: October 28, 2015
Effective Date: July 1, 2015
Topics: Financing & Reimbursement

Michigan
This SPA proposed to establish a pharmacy product reimbursement category related to physician administered injectable drugs.
Approval Date: October 27, 2015
Effective Date: July 1, 2015
Topics: Financing & Reimbursement

Connecticut
Reduces the income limit for the mandatory parents and caretaker relatives eligibility group.
Approval Date: October 27, 2015
Effective Date: August 1, 2015
Topics: Financing & Reimbursement

Washington
This SPA updated the effective date for fee schedules for various programs and incorporated language to eliminate quarterly SPA submissions that simply updated the effective date.
Approval Date: October 27, 2015
Effective Date: April 1, 2015
Topics: Financing & Reimbursement Program Administration

Hawaii
This SPA defines the family size under MAGI methodology as counting a pregnant woman as one person when determining the family size of other individuals in the pregnant woman's household.
Approval Date: October 27, 2015
Effective Date: April 1, 2015
Topics: Benefits Program Administration

Maryland
This SPA clarifies that mental health services provided in an Intermediate Care Facility for Addictions are reimbursed as part of the JCF-A provider's per diem rate and not separately.
Approval Date: October 27, 2015
Effective Date: July 1, 2015
Topics: Financing & Reimbursement

Ohio
Payment for services: Targeted Case Management services provided to individuals with intellectual disabilities.
Approval Date: October 27, 2015
Effective Date: January 1, 2015
Topics: Financing & Reimbursement

Idaho
Sets reimbursement for services provided in a freestanding mental health facility at 91 percent of the Medicare rate for dates of service the participant is a resident of the facility.
Approval Date: October 26, 2015
Effective Date: July 2, 2015
Topics: Financing & Reimbursement