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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 9751 - 9760 of 15783

Washington
Changes the payment methodology for Ambulatory surgical Centers which included grouping ASC's into nine payment groups and the addition of a multiple-precedure discounting algorithm.
Approval Date: October 21, 2015
Effective Date: August 4, 2015
Topics: Financing & Reimbursement

Georgia
Changes Medicaid inpatient prospective system methodology and payment rates.
Approval Date: October 21, 2015
Effective Date: July 1, 2015
Topics: Financing & Reimbursement

Nebraska
Increases the Personal Needs Allowance for persons who are institutionalized to $60 for an individual and $120 for a couple.
Approval Date: October 20, 2015
Effective Date: August 29, 2015
Topics: Financing & Reimbursement

Connecticut
Revises the coverage limits for orthodontic services.
Approval Date: October 16, 2015
Effective Date: July 15, 2015

Michigan
Allows Indian Health Centers to receive the Indian Health Service all-inclusive encounter rates for eligible services provided.
Approval Date: October 15, 2015
Effective Date: February 1, 2015

South Carolina
Modifies the State's reimbursement methodology for setting payment rates for nursing facility services.
Approval Date: October 15, 2015
Effective Date: October 1, 2015
Topics: Financing & Reimbursement

Nebraska
Purpose of the SPA is to align state plan authority for managed care, with the 1915(b) amendment approved on August 25, 2015. SPA No. 15-0004 requires mandatory enrollment into physical health for children with special healthcare needs eligible through a subsidized adoption; individuals eligible for coverage through the Breast and Cervical Cancer Prevention program, and carves in hospice services and non-emergency transportation provided by ambulances into the physical health benefits package for the special needs children and American Indians/Alaskan Native populations. The SPA notes that effective July 1, 2015, the MCO contracts awarded effective July 1, 2015, were procured through sole sourcing. Lastly, this SPA updated language that references "mental retardation" to now reflect "intellectual disability".
Approval Date: October 14, 2015
Effective Date: July 1, 2015
Topics: Program Administration

Louisiana
To amend the inpatient hospital methodology to reinstate the additional reimbursement for hemophilia blood products purchased by non-rural non-state acute care hospitals.
Approval Date: October 14, 2015
Effective Date: July 1, 2015
Topics: Financing & Reimbursement

Tennessee
Incorporates the MAGI-Based Eligibility Group into TN's State Plan.
Approval Date: October 14, 2015
Effective Date: January 1, 2014
Topics: Program Administration

Washington
Amends the Alternative Benefit Package for the new adult expansion group to account for programmatic changes made to the State Plan in 2015, subsequent to its original approval including services provided through the Community First Choice State Plan Option approved in WA-15-0012.
Approval Date: October 14, 2015
Effective Date: July 1, 2015
Topics: Benefits Program Administration