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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, in accordance with Section 113 of the Childrens Health Insurance Program Reauthorization Act (CHIPRA), eliminates the previous requirements for deemed newborn Medicaid eligibility that the newborn must come home from the hospital to live with the mother, remain a member of the mothers household, and that the mother remain eligible for Medicaid, or would remain eligible if still pregnant. By virtue of this change, all newborns born to women covered by Medicaid for the child's birth, including coverage of an alien for labor and delivery as emergency medical services, are now covered as mandatory categorically needy.
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 modifies qualification criteria for supplemental payment based on quality indicators to formulate the payments.
Summary: Implements a rate reduction effective for claims with dates of service from October 1,2011 to September 30, 2012 for all non-institutional services except as otherwise noted. Inthat period, reimbursement will be reduced by 5 percent of the payment that otherwise would have been made under the methodology in effect as of October 1, 2010.
Summary: This SPA implements an outpatient hospital reimbursement rate reduction effective for claims with dates of service from October 1, 2011 to September 30, 2012.
