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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: This SPA discontinues the enrollment cap and change the rate methodology used for the Program of All-Inclusive Care for the Elderly (PACE) calculation of capitation rates for CY2013 for the state's program.
Summary: Amends fees for selected services provided by certain primary care physicians to match 100% of Medicare rates for calendar years 2013 and 2014 and amends fees for vaccine administration under Vaccines for Children Program to match 100% of Medicare rates for calendar years 2013 and 2014.
Summary: Updating the state's pediatric vaccine reimbursement rate page to reflect current vaccine administration payment information. This rate adheres to the regional maximum allowed rate for administration of this vaccine as noted by the Center for Disease Control and Prevention (CDC) for the Vaccines for Children (VFC) program.
Summary: Proposes a new target amount per discharge and child psychiatric per diems for the new entity created by the merger of two hospitals within the State.