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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 allows the State to establish programs to contract with one or more Medicaid Recovery Audit Contractors (RAC), in accordance with Section 6411 of the Affordable Care Act. The purpose of the Medicaid RAC is to identify overpayments and underpayments to recoup overpayments under the State Plan and under any waiver of the State Plan.
Summary: This SPA ensures compliance with the consultation requirements of Section 5006( e) of the American Recovery and Reinvestment Act. In Marylands case, it requires consultation with the one Urban Indian Organization (UIO) in the State, on Medicaid and Childrens Health Insurance Program SPAs, proposed waivers, waiver extensions, waiver amendments, and waiver renewals having a direct impact on Indians, Indian health programs, and/or UIOs.
Summary: This SPA, in accordance with Section 115 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPP A), exempts from the Medicaid estate recovery process the Medicare cost sharing benefits paid by the Medicaid program under the Medicare Savings Program for categories of Medicare and Medicaid dual eligibles aged 55 and older, with dates of service on or after January 1, 2010.
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: Updates the rate methodology for a Chronic Desease an Rehabilitation hospital that had no fewer than five hundred licensed beds as of June 30, 2007.
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.
