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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 discontinues disproportionate share hospital payments to out-of-state hospitals and modifies the qualification criteria for children's hospitals to receive DSH payments.
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.
Summary: This SPA removes State Plan language that allows for the Children's Outpatient Hospital Adjuster Pool to be funded as a Title XIX/Medicaid payment. The payment has been converted to a Title XXI/Childrens Health Insurance Program (CHIP) funded payment.
Summary: This SPA implements the use of an alternative payment methodology (APM) to reimburse Federally Qualified Health Centers (FQHCs) for medical and dental services.
Summary: Provides for an exemption from estate recovery in an amount equal to the benefits paid by certain LTC insurance policies, where those benefits were disregarded in the determination of an individual's Medicaid eligibility.
