Non-Institutional Services - Status

SPA Number Description Original Submission and Date Approved Submission and Date
SPA 11-01 Active Pharmaceutical Ingredients (APIs) Original Submission: March 31, 2011 Approved: September 22, 2011
SPA 11-05 Transitional Medical Assistance Eligibility Criteria Change Original Submission: December 13, 2011 Approved: March 5, 2012
SPA 11-06 Tribal Consultation Procedures Original Submission: May 31, 2011 Approved: August 4, 2011
SPA 11-07A Supplemental Medicaid Payments for SUNY Physicians Supplemental Medicaid Payments for Physicians - HHC Original Submission: June 15, 2011 Approved: February 25, 2013
SPA 11-07B Supplemental Medicaid Payments for Physicians - Public Benefit Corporations Original Submission: June 30, 2011 Approved: February 25, 2013
SPA 11-07C Supplemental Medicaid Payment for Physicians - HHC Nassau and Westchester Original Submission: June 21, 2012 Approved: February 25, 2013
SPA 11-11 AIDS - Adult Day Health Care Original Submission: June 7, 2011 Approved: January 9, 2012
SPA 11-13 Outpatient UPL Payments - Non-State Owned or Operated Government General Hospitals Original Submission: June 6, 2011 Approved: Pending
SPA 11-14 NYC & Non-NYC Personal Care R & R Original Submission: June 15, 2011 Approved: July 26, 2011
SPA 11-15 Home Care R & R Original Submission: June 9, 2011 Approved: September 7, 2011
SPA 11-21 2011 Cost Containment - NI Original Submission: June 30, 2011 Approved: August 31, 2012
SPA 11-26 Assist Preservation of Essential Safety-Net Original Submission: March 20, 2012 Approved: Pending
SPA 11-28 Behavioral Health Utilization Controls Original Submission: June 17, 2011 Approved: August 23, 2012
SPA 11-32 Align Medicare Part B Clinic Coinsurance with Medicaid Coverage Rates Original Submission: September 20, 2011 Approved: December 19, 2011
SPA 11-36 Payment for Perscription Footwear with Maximum Fees Original Submission: June 17, 2011 Approved: August 11, 2011
SPA 11-37 Establish Utilization Limits for Physical Therapy, Occupational Therapy, and Speech Therapy/Pathology Original Submission: June 17, 2011 Approved: September 14, 2011
SPA 11-39 Preschool/School Supportive Health Services Program (SSHSP) Cost Study Original Submission: December 14, 2011 Approved: Pending
SPA 11-50 Control CHHA Utilization by Implementing Provider Specific Aggregate Annual Spending Caps Original Submission: June 10, 2011 Approved: August 25, 2011
SPA 11-51 CHHA Episodic Pricing Original Submission: January 25, 2012 Approved: April 4, 2012
SPA 11-53 Eliminate separate payment rates for AIDS nursing services in CHHAs Original Submission: June 15, 2011 Approved: August 17, 2011
SPA 11-56 Health Home for High-Cost, High-Need Enrollees Original Submission: November 8, 2011 Approved: Februray 3, 2012
SPA 11-59 FQHC Downstate for APGs Original Submission: June 19, 2011 Approved: August 25, 2011
SPA 11-61 Reduced Pharmacy Reimbursement and Dispensing Fees Original Submission: June 9, 2011 Approved: August 10, 2011
SPA 11-62 Early Intervention 5% Reduction and Update Early Intervention Wage Equalization Factor Adjustment Original Submission: June 17, 2011 Approved: December 12, 2012
SPA 11-66 Eliminate 2011 Trend Factor - NI Original Submission: June 30, 2011 Approved: August 6, 2012
SPA 11-67 Establish Payment Amounts and Dispensing Fees for Prescription Drugs Original Submission: June 15, 2011 Approved: July 21, 2011
SPA 11-72 Across the Board Reduction - Non-Institutional Original Submission: June 30, 2011 Approved: December 8, 2011
SPA 11-73 Diabetes Self Management Training Original Submission: September 30, 2011 Approved: December 16, 2011
SPA 11-76 New Models of Payment for Patient-Centered Medical Homes (PCMH) Original Submission: June 27, 2011 Approved: May 9, 2012
SPA 11-83 Termination of Targeted Case Management Programs: TASA, CONNECT and NBA Original Submission: December 30, 2011 Approved: August 7, 2012
SPA 11-88 OMH - 2011-12 Residential Treatment Facilities (RTF) Rate Freeze Original Submission: September 30, 2011 Approved: May 25, 2012
SPA 11-89 Definition of Terminal Illness Original Submission: May 22, 2012 Approved: Pending
SPA 12-01 January 2012 Hospital OP APG Weight Adjustments Original Submission: March 27, 2012 Approved: Pending
SPA 12-02 January 2012 Freestanding Clinic APG Weight Adjustments Original Submission: March 27, 2012 Approved: Pending
SPA 12-03 OPWDD-Rate Setting for State Operated Intermediate Care Facilities Original Submission: June 30, 2012 Approved: March 28, 2013
SPA 12-05 Case Management Services Target Group M - First-Time Mothers/Newborn Original Submission: March 20, 2012 Approved: September 6, 2012
SPA 12-08 Termination of Medication Therapy Management (MTM) Services Original Submission: March 26, 2012 Approved: June 7, 2012
SPA 12-09 Health Homes - Addition of Shared Savings Component of Payment Methodology Original Submission: March 28, 2012 Approved: Pending
SPA 12-10 Health Homes - Phase II Counties Original Submission: May 7, 2012 Approved: December 4, 2012
SPA 12-11 Health Homes - Phase III Counties Original Submission: May 10, 2012 Approved: December 4, 2012
SPA 12-13 April and July 2012 Hospital OP APG Weight Adjustments Original Submission: June 25, 2012 Approved: Pending
SPA 12-14 April and July 2012 Freestanding Clinic APG Weight Adjustments Original Submission: June 26, 2012 Approved: Pending
SPA 12-15 Reimbursement to private practicing podiatrists for podiatry services furnished to Medicaid elegible adults, age 21 and older, with a diagnosts of diabetes mellitus Original Submission: June 28, 2012 Approved: September 27, 2012
SPA 12-16 Lactation Counseling Original Submission: June 28, 2012 Approved: December 28, 2012
SPA 12-19 Revisions to Episodic Pricing Original Submission: June 4, 2012 Approved: August 27, 2012
SPA 12-30 OPWDD-Rate Setting for Medicaid Service Coordination Original Submission: June 30, 2012 Approved: Pending
SPA 12-31 $25M Reduction to Hospital APG Investment Original Submission: June 30, 2012 Approved: Pending
SPA 12-33 Medicaid Transportation Management Original Submission: September 28, 2012 Approved: April 29, 2013
SPA 12-34 Assist Preservation of Essential Safety-Net - CHHAs Original Submission: September 28, 2012 Approved: Pending
SPA 12-35 Coverage of Benzodiazepines and Barbiturates as a Part D Drug Original Submission: January 28, 2013 Approved: March 15, 2013
SPA 12-38 October 2012 and January 2013 Hospital OP APG Weight Adjustments Original Submission: December 27, 2012 Approved: Pending
SPA 12-39 October 2012 and January 2013 Freestanding Clinic APG Weight Adjustments Original Submission: December 27, 2012 Approved: Pending
SPA 13-03 Physician Home Visits Original Submission: March 25, 2013 Approved: Pending
SPA 13-04 Increase Primary Care Service payments for Physicians Original Submission: March 29, 2013 Approved: May 30, 2013
SPA 13-09 2013 Outpatient UPL Payments Original Submission: June 26, 2013 Approved: Pending
SPA 13-12 $25M APG Investment Reduction that was implemented effective beginning 05/01/12 applicable to voluntary hospitals only effective 04/01/13 Original Submission: June 26, 2013 Approved: Pending
SPA 13-15 Article 28, 31 & 32 Service Integration - Freestanding Clinics Original Submission: March 29, 2013 Approved: Pending
SPA 13-16 2012 D & T UPL Payments - HHC & Non-HHC (for periods 2/1/13-3/31/13 & 4/1/13-3/31/14) Original Submission: January 31, 2013 Approved: Pending
SPA 13-18 Health Homes - Extension of Legacy Rates Original Submission: March 26, 2013 Approved: June 18, 2013
SPA 13-22 2% Across the Board Reduction - 2-Year Extension - NI Original Submission: June 26, 2013 Approved: Pending
SPA 13-25 2012 Cost Containment - IP Original Submission: June 21, 2013 Approved: Pending
SPA 13-26 Preventive Services - NY Medicaid covers and reimburses USPSTF Grade A and B preventive services and approved vaccines recommended by ACIP, and their administration,, without cost-sharing, when provided in a practitioner's office. Original Submission: March 26, 2013 Approved: June 18, 2013
SPA 13-29 Supplemental Rebate Program Original Submission: June 24, 2013 Approved: Pending
SPA 13-33 Eliminate Trend Factor Adjustments - NI Original Submission: June 10, 2013 Approved: Pending
SPA 13-34 CHHA R&R Attestations Original Submission: June 26, 2013 Approved: Pending
SPA 13-45 Debt Service Reimbursement for Adult Home Converting to ALPs Original Submission: June 24, 2013 Approved: Pending
SPA 13-46 Extend APG Methodology Original Submission: April 24, 2013 Approved: July 16, 2013
SPA 13-47 Apr 2013 Freestanding Clinic APG Weight Adjustments Original Submission: June 24, 2013 Approved: Pending
SPA 13-48 Apr 2013 Hospital OP APG Weight Adjustments Original Submission: June 24, 2013 Approved: Pending

Additional Service Categories

Disclaimer:
The proposed State Plan Amendments are not final and are subject to further revisions which may not be reflected on this website prior to final approval and inclusion in the State Plan.