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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: 1915(i) State Plan Home and Community-Based Services (HCBS), Behavioral and Primary Healthcare Coordination Services; and IN.02.001 - Amendment to 1915(b)(4) waiver, Adult Mental Health Habilitation and Behavioral and Primary Healthcare Coordination Services
Summary: Conversion to from 209(b) to 1634 status, adoption of optional ABD category to 100% FPL, and implementation of income disregards for the Medicare Savings Program to increase QMB to 150% FPL, SLMB to 170% FPL, and QI to 185% FPL.
Summary: Removes the 20 mile radius restriction for telernedicine services provided by Federally Qualified Health Centers (FQHCs), Rural Health Centers (RHCs), Community MentalHealth Centers (CMHCs) and critical access hospitals. Provides reimbursement for telehealth services to horne health agencies.
Summary: The purpose of this SPA is to update information regarding the staffing of Private Duty Nursing; specifically, the addition of Certified Nursing Assistants and Home Health Aides.
Summary: This SPA describes the methodology used by the state for determining the appropriate FMAP rates, including the increased FMAP rates, available under the provisions of the Affordable Care Act applicable for the medical assistance expenditures under the Medicaid program associated with enrollees in the new adult group adopted by the state and described in 42 CFR 435.119.
Summary: Extension of the 5 percent rate reduction for services provided in outpatient hospital settings and end-stage renal disease clinics through December 31 2013E ffective January 1 2014 through June 30 2015 the rate reduction for outpatient hospitals will be decreased to 3 percent; Effective January 1, 2014, the rate reduction for end-stage renal disease clinics will be eliminated; and -Modifies the Hospital Assessment Fee Methodology.
