Persius/hicric huggingface dataset:
DEPARTMENT OF HEALTH & HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, Maryland   21244-1850 
 
   
 
 
 
          RE: Calendar Year (CY) 2013 Oct - Dec Phased- 
        down State Contribution Final Per-Capita Rates  
 
June 28, 2013 
 
 
Dear State Medicaid Director: 
 
As you know, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) 
requires that the Centers for Medicare & Medicaid Services (CMS) notify each State of its per capita drug 
payment expenditure amount. Payments for the phased-down State contribution are made on a monthly 
basis. These payments are defined by the MMA to be the product of the annual per capita full dual-
eligible drug payment amount and the monthly State enrollment of full dual eligibles.  
 
This letter is to notify you of the phased-down State contribution full dual-eligible per capita Medicaid 
drug payment amount for October - December 2013, as required by the MMA.  
 
Oct-Dec 2013 phased-down State contribution per capita rates are shown in Attachment 1. The per capita 
drug expenditure amount for Oct-Dec 2013 is based on the value for Jan-Sep 2013, adjusted for the 
change in FMAP, if any, between FY 2013 and FY 2014. 
 
Questions regarding these calculations may be directed to Carolyn Lawson, Division of Information 
Analysis and Technical Assistance, Data & Systems Group, at 410-786-0704 or via email at 
Carolyn.Lawson@cms.hhs.gov. 
 
 
Sincerely, 
 
/s/ 
 
            Elaine Olin 
            Director, Data & Systems Group 
 
 
 
 
 
 
 
 
  ATTACHMENT 1: Phased-down State Contribution Rates Oct - Dec 2013 
 
STATE  STATE NAME  OCT-DEC 2013 
AK  Alaska  153.42 
AL  Alabama  67.46 
AR  Arkansas  57.95 
AZ  Arizona  51.63 
CA  California  103.70 
CO  Colorado  133.62 
CT  Connecticut  164.38 
DC  District of Columbia  58.96 
DE  Delaware  117.76 
FL  Florida  118.20 
GA  Georgia  80.99 
HI  Hawaii  92.06 
IA  Iowa  119.31 
ID  Idaho  83.88 
IL  Illinois  134.32 
IN  Indiana  91.63 
KS  Kansas  120.73 
KY  Kentucky  80.26 
LA  Louisiana  99.67 
MA  Massachusetts  110.07 
MD  Maryland  140.42 
ME  Maine  90.05 
MI  Michigan  67.06 
MN  Minnesota  135.53 
MO  Missouri  125.92 
MS  Mississippi  55.63 
MT  Montana  90.63 
NC  North Carolina  94.31 
ND  North Dakota  117.77 
NE  Nebraska  127.13 
NH  New Hampshire  156.10 
NJ  New Jersey  167.95 
NM  New Mexico  56.11 
NV  Nevada  93.86 
NY  New York  123.84 
OH  Ohio  123.53 
OK  Oklahoma  73.36 
OR  Oregon  101.10 
PA  Pennsylvania  134.66 
RI  Rhode Island  133.25 
SC  South Carolina  55.79 
SD  South Dakota  127.23 
TN  Tennessee  106.56 
TX  Texas  86.61 
UT  Utah  92.81 
VA  Virginia  141.42 
VT  Vermont  115.13 
WA  Washington  133.88 
WI  Wisconsin  113.76 
WV  West Virginia  71.97 
WY  Wyoming  147.81
DEPARTMENT OF HEALTH & HUMAN SERVICES 
Health Care Financing Administration  
 Center for Medicaid and State Operations 
7500 Security Boulevard 
Baltimore, MD 21244-1850 
October 1, 1997  
Dear State Medicaid Director:  
This is to inform you of two sections of the Social Security Act (the Act) that have been affected by the Balanced Budget Act of 1997. 
Section 4454 amended section 1902(a) of the Act to remove Christian Science Sanitoria as an optional Medicaid service and to 
substitute coverage of nonmedical health care institutions as defined in a new section 1861(ss)(1) of the Act. Section 4742 repealed 
section 1903(I)(12) of the Act regarding Medicaid physician qualification requirements.  
Section 4454  
The statutory provisions in Section 4454, Coverage of Services in Religious Nonmedical Health Care Institutions Under the Medicare 
and Medicaid Program, became effective for services provided on or after August 5, 1997. Existing regulations at 42 CFR 440.170(b) 
(Services of Christian Science nurses) and (Services in Christian Science sanatoriums) are no longer in force, and new regulations will 
be issued by July 1, 1998.  
The Conference Report on the Section 4454 provisions indicates that the statutory change was necessary to remove the sect-specific 
designation and substitute a sect-neutral accommodation. As noted in the last paragraph of the Conference Agreement for this section, 
the conferees recognized that there are religious nonmedical institutions that have been participating as providers since the inception 
of the Medicare and Medicaid programs. We believe that those institutions will meet the new statutory requirements, and Federal 
reimbursement will therefore continue to be available for those institutions and services during the interim period prior to the 
publication of new regulations. Enclosed are copies of the legislation and Conference Agreement for your information.  
Section 4742  
Section 1903(I)(12) of the Act established minimum qualifications for a physician who furnishes services to a child under age 21 or to 
a pregnant woman. Section 4742 repealed this section of the Act, effective August 5, 1997. As a result, section 6400.2, Physician 
Services to Children Under 21, and section 6400.3, Physician Services to Pregnant Women, of Part 6 of the State Medicaid Manual 
(SMM) are not applicable for services furnished on or after August 5, 1997. A formal revision to the SMM, deleting these sections, 
will be forthcoming.  
If you have any questions, please contact the Division of Medicaid and State Operations in your respective HCFA Regional Office.  
Sincerely yours,  
/s/  
Sally K. Richardson   
Director   
Center for Medicaid and State Operations   
 
 
Enclosure  
cc:  All HCFA Administrators  All HCFA Associate Administrators for Medicaid and State Operations  Lee Partridge - American 
Public Welfare Association  Joy Wilson - National Conference of State Legislatures  Jennifer Baxendell - National Governors' 
Association
SMDL #01-027  
August 7, 2001 
Dear State Medicaid Director: 
On behalf of the Center for Medicaid and State Operations in the Centers for 
Medicare & Medicaid Services, I would like to encourage you to apply for the 
upcoming Policy Academies for State and Local Policymakers - Improving Access to 
Mainstream Services for Persons Who Are Homeless. These Academies will focus on 
improving access to mainstream services for persons who are homeless by bringing 
together State-level senior policymakers with local stakeholders to develop a State 
Action Plan. 
As you know, States play a pivotal role in determining eligibility for accessing 
mainstream Federal and State-funded health and human service programs - 
including access to these programs by people who are homeless. Benefits provided 
through the Medicaid and State Children's Health Insurance Programs can be critical 
to many eligible persons who are homeless, so your participation in these discussions 
is especially important. 
Enclosed please find a letter from the Department of Health and Human Services 
Secretary Tommy Thompson that was recently mailed to your Governor announcing 
the opportunity to apply for these academies along with the Request for Applications. 
The first Policy Academy will be held in Santa Fe, New Mexico on November 27-28, 
2001 and will focus on homeless families with children. The second Academy will 
occur in February/March of 2002 and will focus on people who are "chronically 
homeless," including those with mental health and/or substance abuse issues. Your 
State may apply to participate in one or both Academies. As you will see from the 
enclosed Application Kit, travel, hotel and lodging expenses will be covered for up to 
10 team members for each State Team who submits a successful application. The 
deadline for applications is August 31, 2001. 
The Policy Academies are being funded and developed by agencies within the U.S. 
Departments of Health and Human Services and Housing and Urban Development. In 
addition there are several national partnering organizations offering support of these 
meetings. 
I encourage you to participate in this important opportunity - please consider 
contacting your Governor's office to inquire about assembling a State team. For 
further information on the Policy Academies, please contact Lynnette Araki, M.P.H, 
Health Resources Services Administration at (301) 443-6204 or George Kanuck, 
Center for Substance Abuse Treatment at (301) 443-8642. 
Sincerely, 
/s/  Dennis G. Smith  
Director  
Center for Medicaid and State Operations 
2 Enclosures 
cc:  
All CMS Regional Administrators 
All CMS Associate Regional Administrators For Medicaid and State Operations 
Lee Partridge  
Director, Health Policy Unit  
American Public Human Services Association 
Joy Wilson  
Director, Health Committee  
National Conference of State Legislatures 
Matt Salo  
Director of Health Legislation  
National Governors' Association
DEPARTMENT OF HEALTH & HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, Maryland 21244-1850 
 
 
 
Center for Medicaid and CHIP Services 
 
CMCS Informational Bulletin 
 
 
DATE:  June 15, 2012 
 
FROM:  Cindy Mann, Director 
    Center for Medicaid and CHIP Services (CMCS) 
 
SUBJECT:  Updated FDA Statement on Compounded Versions of hydroxyprogesterone 
caproate (the active ingredient in Makena) 
 
 
The U.S. Food and Drug Administration (FDA) updated its statement on compounded versions 
of hydroxyprogesterone caproate (the active ingredient in Makena) today.  Please see 
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm308546.htm.   As 
explained in a November 8, 2011 statement, FDA received information from Makenas sponsor, 
K-V Pharmaceuticals regarding the potency and purity of samples of bulk hydroxyprogesterone 
caproate active pharmaceutical ingredients (APIs) and compounded hydroxyprogesterone 
caproate products.  As explained in the updated statement, the FDA has also conducted its own 
sampling and analysis of compounded hydroxyprogesterone caproate products and the bulk APIs 
used to make them. FDA states that the analysis of this limited sample of compounded 
hydroxyprogesterone caproate products and APIs did not identify any major safety problems, but 
noted that approved drug products, such as Makena, provide a greater assurance of safety and 
effectiveness than do compounded products. Finally, FDA stated that the compounding of any 
drug, including hydroxyprogesterone caproate, should not exceed the scope of traditional 
pharmacy compounding.   States may, under appropriate circumstances, cover APIs as incident 
to another service category or, as a pharmacy service, if such coverage is consistent with the 
State plan. 
 
We would like to remind States of their responsibility to cover FDA approved products, such as 
Makena, that qualify as covered outpatient drugs under the Medicaid drug rebate program.   Any 
prior authorization procedures for such drugs must be administered in accordance with Section 
1927(d) of the Social Security Act, without imposing unreasonable conditions.
DEPARTMENT OF HEALTH & HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, Maryland 21244-1850 
 
Center for Medicaid and State Operations 
 
April 28, 2008                 SMDL #08-002 
 
Dear State Medicaid Director: 
 
The purpose of this letter is to provide a Medicaid State Plan amendment (SPA) preprint that 
States may use to comply with the requirements of sections 1936 and 1902(a)(69) of the Social 
Security Act (the Act) (section 6034 of the Deficit Reduction Act of 2005 (DRA)).  
 
Section 6034 of the DRA established the Medicaid Integrity Program in section 1936 of the Act 
and identified certain of the Centers for Medicare & Medicaid Services (CMS) responsibilities 
for carrying out the activities of the program, including contracting with entities that will audit 
provider claims and identify overpayments, and providing effective support and assistance to the 
States to combat provider fraud and abuse.  This provision also established section 1902(a)(69) 
of the Act entitled, State Requirement to Cooperate with Integrity Program Efforts.  Section 
1902(a)(69) of the Act requires that the Medicaid State plan provide that the State must comply 
with any requirements determined by the Secretary to be necessary for carrying out the Medicaid 
Integrity Program established under section 1936. 
 
To assist States, we have attached a preprint that may be used when submitting a SPA to 
implement this provision.  Both an electronic copy and a hard copy of the SPA must be 
submitted simultaneously to the CMS Central Office and to the regional office serving your 
State.  The provisions of section 1902(a)(69) of the Act must be implemented immediately. 
 
If you have any questions on this guidance, please direct them in writing to Ms. Claudia 
Simonson, Centers for Medicare & Medicaid Services, Center for Medicaid and State 
Operations, Medicaid Integrity Group, Division of Field Operations, 233 North Michigan 
Avenue, Suite 600, Chicago, IL 60601 or claudia.simonson@cms.hhs.gov. 
 
Sincerely,  
 
/s/ 
 
          Herb B. Kuhn  
Deputy Administrator 
Acting Director, Center for Medicaid and State Operations 
 
Enclosure  Page 2  State Medicaid Director 
 
cc: 
 
CMS Regional Administrators 
 
CMS Associate Regional Administrators 
    Division of Medicaid and Childrens Health  
 
Barbara Edwards           
NASMD Interim Director 
American Public Human Services Association 
 
Joy Wilson 
Director, Health Committee 
National Conference of State Legislatures 
 
Matt Salo 
Director of Health Legislation 
National Governors Association 
 
Barbara Levine 
Director of Policy and Programs 
Association of State and Territorial Health Officials 
 
Christie Raniszewski Herrera 
Director, Health and Human Services Task Force 
American Legislative Exchange Council 
 
Debra Miller 
Director for Health Policy 
Council of State Governments
DEPARTMENT OF HEALTH AND HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, MD 21244-1850 
 
 
CMCS Informational Bulletin  
 
DATE:  April 30, 2015 
 
FROM:  Vikki Wachino, Director 
    Center for Medicaid and CHIP Services  
 
SUBJECT:  Updated 2015 Spousal Impoverishment Standards  
 
Certain Medicaid income and resource standards are adjusted annually in accordance with 
changes in the Supplemental Security Income (SSI) federal benefit rate and the Consumer Price 
Index (CPI). These include some of the standards described in section 1924 of the Social 
Security Act (the Act), which describes the financial eligibility rules (the spousal 
impoverishment rules) that apply when married individuals seek coverage of certain long-term 
services and supports. 
 
While some of the spousal impoverishment standards (such as the maximum community spouse 
income maintenance allowance and community spouse minimum and maximum resource 
allowances) are adjusted each January, section 1924 of the Act directs that the community 
spouses minimum monthly maintenance allowance (MMMNA) be adjusted, in accordance with 
changes to the federal poverty level, effective July 1st of each year. Additionally, as the 
community spouses monthly housing allowance (which is the basis for determining if the 
community spouse may have an excess shelter allowance) is calculated based on a percentage of 
the MMMNA, the excess shelter allowance is adjusted each July 1st as well.   
 
Included with this informational bulletin are the revised 2015 SSI and Spousal Impoverishment 
Standards chart that display the updated MMMNA and Community Spouse Monthly Housing 
Allowances. These standards are also available on Medicaid.gov at 
http://medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Eligibility/Spousal-
Impoverishment-Page.html 
 
Please update your standards in accordance with this information. 
 
If you have any questions or need additional information, please contact Gene Coffey at 410-
786-2234 or Gene.Coffey@cms.hhs.gov.
DEPARTMENT OF HEALTH AND HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, MD 21244-1850 
 
Center for Medicaid and CHIP Services 
 
CMCS Informational Bulletin 
  
 
DATE:  December 5, 2011 
 
FROM:  Cindy Mann  
  Director 
  Center for Medicaid and CHIP Services (CMCS) 
 
SUBJECT:  Announcing Medicaid.gov 
 
The Center for Medicaid and CHIP Services (CMCS) is pleased to announce the initial launch of 
http://medicaid.gov/, the first Federal government website devoted to the policies -- and the 
people -- of Medicaid and the Childrens Health Insurance Program (CHIP).  This website is the 
culmination of efforts at the Center for Medicaid and CHIP Services to revitalize and reorient the 
information the Federal government makes available about these programs.  As part of our 
commitment to transparency and information sharing, Medicaid.gov brings to the forefront the 
items that States, the health policy community and other stakeholders have said they care about 
most, including: our Federal policy guidance; lists of pending and approved waivers; highlights 
of our Affordable Care Act implementation efforts; State-specific program information and data; 
and improved search capabilities.   
  
The new site design provides information about the Medicaid and CHIP programs that is 
organized and updated to reflect todays policy issues and priorities.  We also tried to provide 
easy access to answers to the most commonly asked questions and requests for information. 
Finally, Medicaid.gov includes a section for consumers to help them get information about the 
Medicaid or CHIP program in their State and links to http://www.healthcare.gov/ and 
www.insurekidsnow.gov where broader information about health coverage options is now 
available.   
  
Of course, this site is a work in progress.  We wanted to make key elements available as quickly 
as possible while we work on ongoing improvements in functionality, opportunities for 
collaboration and interaction, and to augment the availability of data in the coming months and 
years.  We want Medicaid.gov to become a key resource for States and for all of our partners.   
  
We hope that you will let us know what you think of the new site and what you would like us to 
prioritize as we continue to build our capacity.  After browsing the site, feel free to send your 
feedback through the CMS Idea Factory (http://cmsideas.uservoice.com/forums/141980-
medicaid-gov).  
  
Thank you for your commitment to these critical health coverage programs and the nearly 60 
million Americans they serve.
DEPARTMENT OF HEALTH & HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, Maryland   21244-1850 
 
 
CMCS Informational Bulletin 
 
DATE:  November 25, 2014 
 
FROM:  Cindy Mann 
      Director 
      Center for Medicaid and CHIP Services  
 
SUBJECT:  2015 SSI and Spousal Impoverishment Standards  
 
This CMCS informational bulletin is to provide an update on the 2015 Supplemental Security 
Income (SSI) and Spousal Impoverishment Standards.  
 
Certain Medicaid income and resource standards are adjusted beginning each January in 
accordance with changes in the SSI federal benefit rate and the Consumer Price Index (CPI). 
Many states offer, for example, categorical eligibility to individuals who are not receiving SSI 
but who meet the financial eligibility requirements of the program, as authorized by 
1902(a)(10)(A)(ii)(I) of the Social Security Act (the Act). Similarly, most states have adopted the 
special income level institutional eligibility category authorized under Section 
1902(a)(10)(A)(ii)(V) of the Act, the maximum income standard for which is 300% of the SSI 
federal benefit rate. Additionally, certain eligibility standards relating to coverage of long-term 
services and supports, including the home equity limitation in Section 1917(f) of the Act and 
elements of the spousal impoverishment statute in Section 1924, are increased each year based 
on increases in the CPI for all urban consumers.  
 
Included with this informational bulletin is the 2015 SSI and Spousal Impoverishment Standards 
chart that displays the new standards. These standards are also available on Medicaid.gov at 
http://medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Eligibility/Spousal-
Impoverishment-Page.html. Please update your standards in accordance with this information for 
the provisions that become effective on January 1, 2015.  
 
If you have any questions or need additional information, please contact Gene Coffey at  
410-786-2234 or Gene.Coffey@cms.hhs.gov.
DEPARTMENT OF HEALTH AND HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, MD 21244-1850 
 
Center for Medicaid, CHIP and Survey & Certification 
 
CMCS Informational Bulletin 
  
 
DATE:    June 21, 2011 
     
FROM:  Cindy Mann, Director 
  Center for Medicaid, CHIP and Survey & Certification (CMCS) 
 
SUBJECT:   Medicaid Disproportionate Share Hospital (DSH) Audit and Report 
Information  DSH Redistribution State Plan Amendments (SPA) 
 
As we approach the end of most States State plan rate year (SPRY), I am writing to provide you 
a reminder regarding the opportunity to submit a SPA enabling State redistribution of DSH 
payments if your independent certified DSH audit and associated reporting shows that payments 
have been made in excess of the hospital-specific DSH limit. 
        
The 2008 DSH audit and reporting final rule, which implemented section 1001 of the Medicare 
Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), provided a transition 
period to States for SPRYs 2005 through 2010.  This period was designed to allow adequate time 
for the Centers for Medicare & Medicaid Services (CMS), States, auditors, and hospitals to work 
cooperatively in developing and refining DSH reporting and auditing techniques required by 
statute and regulation while attempting to mitigate or to eliminate the immediate and future fiscal 
impact realized by States and hospitals.   
 
Beginning in Medicaid SPRY 2011, to the extent that audit findings demonstrate that DSH 
payments exceed the documented hospital-specific limits, these payments will be treated as 
overpayments to providers that, pursuant to 42 CFR Part 433, Subpart F, trigger the return of the 
Federal share to the Federal government.  However, if the excess DSH payments are 
redistributed by the State to other qualifying hospitals as an integral part of the audit process, the 
Federal share is not required to be returned.  If the State wishes to redistribute DSH payments 
that exceed hospital-specific limits, the Federally approved Medicaid State plan must reflect that 
payment policy.  In order to preserve an effective date for SPRY 2011, States must submit the 
proposed SPA by the last day of SPRY 2011.   
 
States have considerable flexibility in establishing the redistribution methodology, as long as the 
methods and standards are consistent with applicable Federal requirements.  CMS committed to 
providing technical guidance, as requested, to ensure that applicable Federal requirements are 
met.   
 
We look forward to continued efforts and commitment in ensuring that the DSH audits and 
reports comport with section 1923(j) of the Act, implementing regulations at 42 CFR 447.299 
and 42 CFR 447 Subpart D, and related guidance.  Should you have any questions please contact 
Rory Howe at 410-786-4878 or by email at rory.howe@cms.hhs.gov.