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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 proposed amendment, Transmittal Number (TN) 22-0025, updates the Physicians and Other Practitioners Services fee schedules. The requested effective date for the proposed amendment is June 1, 2022.
Summary: This SPA implements Wisconsin's yearly increase to hospital rates. Specifically, this SPA modifies the outpatient Enhanced Ambulatory Patient Grouping Reimbursement Methodology to create a new outpatient payment per visit add-on for outpatient dental services where deep sedation is provided.
Summary: This State Plan Amendment provides an increase to the ground ambulance transport services fee-schedule rates. These services include advanced life support levels one and two, advanced life support level one emergency, basic life support, basic life support emergency, and specialty care transport.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to amend the methodology for retention payments to providers delivering HCBS attendant and nursing services through the provider agency and consumer directed services option in the following state plan services: Community Attendant Services program; Primary Home Care program; day activity and health services; Community first choice (CFC) personal assistance services and CFC habilitation services; 1915(i) Home and Community-Based Services--Adult Mental Health Program; and personal care services.
Summary: Effective for services on or after January 1, 2023, this amendment will modifying Wisconsin's reimbursement methodology as it relates to the number of months a cost report and supporting documentation are required after a facility’s cost reporting period.