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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 adds a new provision for inpatient psychiatric services. Specifically, it establishes rates for acute psychiatric care in general hospital psychiatric units for individuals requiring extended care.
Summary: This SPA transmitted a proposed amendment to Connecticut's approved Title XIX State Plan Lo add authorization requirements to certain highcost, high-utilization procedures.
Summary: This SPA transmitted a proposed amendment to Connecticut's approved Title XIX State Plan to expand the State's Medicaid Program to add hospice as a new benefit.
Summary: This amendment updates the reimbursement methodology for inpatient hospitals participating in South Dakota Medicaid. Specifically, this amendment updates the annual Medicare Diagnostic Related Group (DRG) to reflect the current period and modifies cost outlier thresholds.
Summary: This amendment changes the reimbursement methodology for the estimated acquisition cost (EAC) from average wholesale price (AWP) less 10.5 percent to AWP less 13 percent.
Summary: This SPA proposed an amendment to the State's approved Title XIX State Plan to limit reimbursement for eyeglasses to one pair per year for adults aged 21 or over.
Summary: This SPA transmitted a proposed amendment to Connecticut's approved Title XIX State Plan to expand the State's Medicaid Program to include tuberculosis-related services described under § 1902(z)(2) of the Social Security Act.
Summary: This SPA proposed an amendment to the State's approved Title XIX State Plan to increase the number of allowed individuals in a group therapy visit from eight (8) to twelve (12).
Summary: This amendment updates the inpatient hospital reimbursement methodology pertaining to the elimination of in-state hospital cost settlements. In addition, this amendment reduces the percentage of reimbursement available for out-of-state hospitals.
