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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.
Summary: The purpose of this SPA to implement mandatory coverage and reimbursement of COVID-19 testing, vaccine and vaccine administration, and treatment in accordance with Section 9811 of the American Rescue Plan (ARP) Act.
Summary: This State Plan Amendment increases the per diem reimbursement rate from $589.62 to $707.54 for nursing facilities that provide specialized care to ventilator-dependent residents.
Summary: This State Plan Amendment updates Nursing Home reimbursement rates to the 2020 nursing home cost reports. The SPA also updates calculation of the Property and Related Net Per Diem established under the FRV System by increasing the rate for construction cost for nursing facilities from $187.12 to 198.86, as derived from the 2020 RSMeans Building Construction cost data for Nursing Homes.
Summary: This plan amendment the updates the Upper Payment Limit (UPL) program for private ground ambulance providers that provide 911 emergency transport services to Medicaid beneficiaries.