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Medicaid State Plan Amendments
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: Bringing State Plan into compliance relating to setting administration and general reimbursement to a price; removing 8% per year limitation on the growth of health care costs; adding payments for cognitive loss/dementia and ABI, Level II PASRR residents, quality performance and authority to charge and collect a provider fee.
Summary: To bring the State in compliance with what they were actually doing. On August 1, 2008 North Carolina reduced the annual visit limit from 24 to 22 visits (visits are authorized beyond 22 when medically necessary).
Summary: This SPA proposes changes to the District's disproportionate share hospital payment program. Specifically, this plan continues the previously approved recovery and redistribution methodology for DSH payments in excess of hospital-specific-limits. Additionally, this SPA eliminates one of two reductions to DC's annual DSH allotment that allowed DC to expand coverage under approved Medicaid Waivers and eliminates language that made an additional $12.5 million payment to a specific qualified DSH facility. The $12.5 million becomes part of the distribution pool for all DSH hospitals.