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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 amendment revises the State's reimbursement methodology for setting payment rates for hospital services. Specifically, it will amend the plan language to revise inconsistent and ambiguous language and correct examples of the rate setting methodologies.
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: 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 revises the State's reimbursement methodology for setting payment rates for nursing facility services. Specifically, it will implement the Minimum Data Set (MDS) 3.0 to determine the case mix index used to establish payment rates. It also includes language clarifying that the cost of completing the MDS is an allowable cost to be included in determining the payment rates.
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 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 State's reimbursement methodology for setting payment rates for nursing facility services. Specifically, the amendment removes the requirement to limit the Administrative and operating costs of private nursing facilities for the severely disabled to a peer group ceiling.
