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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 State Plan Amendment clarifies Medicaid reimbursement for inpatient hospital care provided to Indian Health Service and Tribal 638 providers.
Summary: These changes implement a temporary reduction (for the remainder of SFY 2010) in the pharmacy dispensing fee from $4.57 to $4.34 and implements a new permanent methodology for the determination of the EAC for specialty drugs at AWP minus 17% as opposed to the non-specialty BAC of AWP minus 12%.
Summary: Removes the five year bar to Medicaid eligibility for children under age 21 as authorized in Section 214 of the Children’s Health Insurance Program Reauthorization Act of 2009.
Summary: Request is being made in accordance to changes to the LTC Partnership Program as directed by the DRA of 2005 and 2009 IA HF 723. Bill directs the IA DHS to amend the Medical Assistance state plan to provide that an asset disregard equal to the amount of the insurance benefits paid to or on behalf of the individual who purchase.
