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: SPA Establishes a Recovery Audit Contracotr (RAC) program to contract with one or more Medicaid contractors for the purpose of identifying upderpayments and overpyaments of Medicaid claims.
Summary: This SPA ensures compliance with the Qualifying Individual Program Supplemental Funding Act of 2008, whereby the State has an eligibility determination system that provides for data matching with medical assistance programs operated by other States in order to prevent duplicate enrollments.
Summary: This amendment modifies the methods and standards for making Medical Assistance payments to nursing facilities (NFs). Specifically, this SPA increases NF reimbursements by reducing the net reduction factor applied to select cost centers used in developing rates and implements a supplemental payment using quality indicators to formulate the payments.
Summary: This SPA defines the States coinsurance payment for Part B claims for all dual Medicare and full Medicaid covered individuals and Qualified Medicare Beneficiary-only individuals.
Summary: Clarifies the limitations place on medical and surgical services proficed by a dentist and corrects the preprint numbering relating to this item.
Summary: This SPA updates a Memorandum of Agreement involving the Department of Health and Mental Hygiene; the Family Health Administration; the Title V Maternal and Child Health Agency; Title X Family Planning Program; and Special Supplemental Nutrition Program for Women, Infants and Children.
Summary: Provides for a technical correction of State plan language regarding the version of Resource Utilization Group/Min Data Set used as part of Nevadas nursing facility rate-setting.
Summary: Section XIV would allow non-state government owned hospitals with approved graduate medical education (GME) programs to received additional Medicaid payments.
Summary: This SPA implements Express Lane Eligibility for children, in which the Maryland Comptroller will identify through annual State income tax returns those families who are below 300 percent of the Federal Poverty Level and who indicate that their children do not have health insurance coverage.
