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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 9961 - 9970 of 15780

California
Updates Year 3 Diagnosis Related Group payments parameters for general acute inpatient services provided by hospitals, effective for inpatient services with dates of admission on or after July 1, 2015.
Approval Date: June 30, 2015
Effective Date: December 31, 2000
Topics: Financing & Reimbursement

Alabama
This SPA proposes to limit the number of outpatient pharmacy prescriptions for all recipients, with certain class exemptions, to five total drugs per month per adult recipient.
Approval Date: June 29, 2015
Effective Date: October 1, 2013

Michigan
Inpatient Rate Update.
Approval Date: June 26, 2015
Effective Date: January 1, 2015
Topics: Financing & Reimbursement

New York
This amendment continues hospital reimbursement adjustments related to potentially preventable readmissions (PPR) and potentially preventable complications (PPC) through March 31, 2015.
Approval Date: June 26, 2015
Effective Date: April 1, 2014
Topics: Financing & Reimbursement

Missouri
Proposed to raise the personal needs allowance (PNA) for institutionalized individuals subject to post-eligibility requirements at 42 CFR 435.733. The PNA is increased for aged, blind and disabled individuals from $45 to $50 per month for an individual and from $90 to $100 per month for a couple; for AFDC-related adults and children from $45 to $50 per month.
Approval Date: June 25, 2015
Effective Date: January 1, 2015
Topics: Financing & Reimbursement

Missouri
Proposed to raise the personal needs allowance (PNA) for institutionalized individuals subject to post-eligibility requirements at 42 CFR 435.733. The PNA is increased for aged, blind and disabled individuals from $40 to $45 per month for an individual and from $80 to $90 per month for a couple; for AFDC-related adults and children from $40 to $45 per month, and for individuals eligible under 42 CFR 435.222 from $40 per month to N/A in accordance with changes made by the Affordable Care Act.
Approval Date: June 25, 2015
Effective Date: January 1, 2014
Topics: Financing & Reimbursement

Rhode Island
Authorizes implementation of a transitional price-based per diem payment methodology for nursing facility services.
Approval Date: June 25, 2015
Effective Date: May 4, 2013
Topics: Financing & Reimbursement

Pennsylvania
Describes Methodology Used by the State for Determining Appropriate FMAP Rates, Including the Increased FMAP Rates, Available Under the Provisions of the Affordable Care Act Applicable for the Medical Assistance Expenditures Under the Medicaid Program Associated with Enrollees in the New Adult Group Adopted by the State.
Approval Date: June 24, 2015
Effective Date: January 1, 2015
Topics: Financing & Reimbursement

Maryland
This SPA updates the State Plan to reflect changes to the State's dental services fee schedule and procedure codes, as well as adding ambulatory surgical centers as a covered service location.
Approval Date: June 24, 2015
Effective Date: January 1, 2015
Topics: Financing & Reimbursement

Texas
This state plan amendment updates the fee schedule for physicians and other practitioners.
Approval Date: June 24, 2015
Effective Date: April 1, 2015
Topics: Financing & Reimbursement