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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 updates the Stale plan to be consistent with CMS required format of separating inpatient Institutional reimbursement sections from outpatient I professional services. This update requires additional updating of all related service sections and are updated to reflect current practices and methods of reimbursement.
Summary: This amendment reduces bed-hold reimbursement for NF residents who are hospitalized or on therapeutic leave; and adds methodology for consolidating two or more NFs and calculating the new reimbursement rate.
