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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: amend Attachment 4.22-B of the state plan to reflect Pennsylvania’s compliance with the third-party liability requirements of the Bipartisan Budget Act of 2018 and the Medicaid Services Investment and Accountability Act of 2019.
Summary: Provides assurance that the state is in compliance with the non-emergency medical transportation (NEMT) requirements outlined in Section 1902(a)(87) of the Social Security Act.
Summary: Certification requirements and delivery methods for Orientation and Mobility Specialists within School-Based Services are being updated within the State Plan.
Summary: This amendment establishes the annual aggregate limit and continues funding for inpatient disproportionate share, outpatient supplemental and direct medical education payments.
Summary: The SPA authorizes the discontinuation of the Medical Assistance Stability inpatient supplemental payment and modification to the reconciliation process to account for the elimination of MA Stability payments.
