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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 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: This amendment revises the rate methodology for Private Psychiatric Hospitals and Substance Abuse Treatment Hospitals. Specifically, it provides a rate increase of 1.1459% for the Private Psychiatric Hospitals and a rate increase of .719% for the Substance Abuse Treatment Hospitals.
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: This amendment specifies cost adjustments for inflation to the Chronic Disease and Rehabilitation hospitals inpatient rate methodology. It also allows a reduction in the payment rate for administrative Day and an update to Per Diem Rate two (2) for private non-acute hospitals that had no fewer than five hundred (500) licensed beds as of June 30, 2007.
Summary: This amendment revises the methodology used to calculate payment rates for inpatient hospital services. Specifically, it modifies the acute inpatient hospital reimbursement methodology for hospital rate year (RY) 2010. In addition, it allows a one-time supplemental payment of $5 .9 million to qualified providers.
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.
Summary: This amendment clarifies that hearing instrument specialist services are provided as other licensed practitioner services pursuant to 42 CFR 440.60 and updates the State plan to reflect the State's new hearing aid replacement policy.
Summary: This amendment complies with Section 1 15 of the Medicare Improvements for Patients and Providers Act of 2008, which requires States to exempt Medicare cost-sharing benefits paid under the Medicare Savings Programs (MSPs) from estate recovery under section 191 7(b)(l) of the Act.
Summary: This SPA extends Medicaid to independent foster care adolescents, in accordance with State legislation, to provide for individuals who were in foster care under the responsibility of the State on their 18th birthday and have not reached the age of 21.
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 by 8.85 percent for certain cost centers and offsets the increase by implementing a light care incentive factor of 0.97.