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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: Change inpatient hospital reimbursement methodology for Native American members to the inpatient hospital per diem (excludes physician/practitioner services). Inpatient for all other members will continue to be paid on the DRG methodology.
Summary: Proposes to amend/clarify state plan language for home health agencies, community mental health centers, and maternal health centers in response to the CMS corrective action plan for approved SPA MS-09-021.
Summary: Clarify when a Medicaid payment is made for medical care or expenses on behalf of a member because of medical malpractice, the department shall have a lien, to the extent of those payments, to all monetary claims which the member may have against third parties. This amendment applies to injuries sustained on or after July 1, 2011.
