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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 establishes reimbursement for non-state Psychiatric Medical Institutions for Children (PMICs) services through the use of provider specific per diem rates, consistent with the Iowa Plan for Behavioral Health.
Summary: This SPA allows individuals, with income between 101-133% of FPL, who use to be mandated into the MarketPlace plan to elect enrolling in the Health and Wellness Plan.
Summary: This SPA discontinues disproportionate share hospital payments to out-of-state hospitals and modifies the qualification criteria for children's hospitals to receive DSH payments.
Summary: Seeks reimbursement for health home services to enrollees with one chronic condition, Bipolar Disorder, and being "at risk" for developing another, Hepatitis B and/or C, in the counties of Wayne, Cabell, Putnam, Kanawha, Raleigh, and Mercer.
Summary: This SPA proposes to remove the drug categories of barbiturates, benzodiazepines, and smoking cessation drugs from the list of drugs that may beexcluded or restricted from coverage from the State Plan effective January 1, 2014, in accordance with the provisions of section 2502 of the Affordable Care Act which amends section 1927(d)(2) of the Social Security Act (the Act).
Summary: This SPA submission replaces MMDL pages replaces S25: Parents and Other Caretaker Relatives; S28: Pregnant Women; S30: Infants and Children under Age 19; and S33: Mandatory Coverage Former Foster Care children; replacing those sections as originally approved in SPA 13-0026-MM1. This SPA is to adding presumptive eligibility determinations for these eligibility groups.
