An official website of the United States government
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
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: Effective December 27, 2020, this amendment continues an additional class of disproportionate share hospital payment to facilities meeting certain low-Income utilization rate (LIUR) and net patient revenue criteria while operating in a medically underserved area.
Summary: This amendment provides additional class of disproportionate share hospital payment to qualifying facilities that promote access to comprehensive inpatient services.
Summary: This amendment establishes the annual aggregate limit and continues funding for supplemental, disproportionate share, and direct medical education payments.
Summary: Allow the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271).
Summary: Continues an additional class of disproportionate share hospital payment to qualifying hospitals
that provide medical and surgical services for ocular disease and injuries
Summary: This SPA authorizes the DHS to continue to make county nursing facility safety net payments to qualifying county nursing facilities in Fiscal Year (FY) 2019-2020. The DHS published a public notice in the Pennsylvania Bulletin on January 11, 2020. To qualify for a safety net payment, the facility must be a county nursing facility both during the period for which the payment is being made and at the time the payment is made. County nursing facilities located in a geographic zone where the Community HealthChoices (CHC) program will be in operation for the entire 2019-2020 fiscal year are not eligible for this payment.
Summary: Aggregate Limits to Inpatient Disproportionate Share, Outpatient Supplemental and Direct Medical Education and Disproportionate Share Hospital and Supplemental Payments to newly enrolled ln-State hospitals that qualify for payments.
Summary: Extension of the Budget Adjustment Factor (BAF) for Rate Years 2019-2020, 2020-2021 and 2021-2022 and BAF Formula for Nonpublic Nursing Facilities for Rate Year 2019-2020.
Summary: Budget Adjustment Factor (BAF) Formula for County Nursing Facilities and Extension of the BAF for Rate Years 2019-2020, 2020-2021 and 2021-2022.