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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: Effective January 1, 2021, this amendment rebases the rate for Outpatient Hospital Services for acute care hospitals using cost reports ending in calendar year 2019.
Summary: This amendment increases the rate for Healthcare Common Procedure Coding System code J7307- Etonogestrel implant system on the physician office and outpatient fee schedule.
Summary: This amendment applies to the 1915(i) HCBS Day Habilitation service. Revises provider qualifications and scope of service to assure that services are delivered by qualified providers and provide a pathway to employment for participants.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to implement a temporary rate increases of 2.3% for home health aide services provided by home health agencies, specifically HCPCS T1004, T1021 effective Sept 1 through October 31, 2020.
Summary: Proposes to allow Physician Assistants to bill independently from the supervising physician. The SPA also establishes a rate payment for Physicians Assistants
Summary: Implements various program changes in Wave 3 of the PCMH+ program. This SPA also sets forth the total amount available for care coordination add-on payments to Federally Qualified Health Centers (FQHCs) participants for 2020 and 2021.
