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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: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to implement a payment rate increases for inpatient hospital services including mental health, obstetrics, newborns, transplants, rehab, trauma and pediatric care. Additionally, payment rates for all deliveries are increased to cover the hospital’s costs of additional Department of Health requirements for newborn screening tests.
Summary: Increases payment rates for dental services (excluding state-operated dental clinics, federally qualified health centers, rural health centers, the Indian Health Service, and tribal 638 facilities).
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to establish a new threshold for determining when to seek recovery of reimbursement from a liable third party for COVID-19 testing and associated laboratory services administered through public health agencies.
Summary: Combines current Alternate Payment Methodologies (APM) into a new APM for Rural Health Centers (RHCs) and Federally Qualified Health Centers (FQHCs). This SPA also provides for COVID-19 vaccine administration fees at the Medicare geographically adjusted rate.
