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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: Revises the DSS fee schedule for durable medical equipment (DME). Specifically, the KO1108 RB modifier (wheelchair component or accessory not otherwise specified) is being reduced from $2000 to $1000. The amount is a soft limit and can be overridden with prior authorization.
Summary: This amendment was submitted to reduce payment rates for medication administration services provided by home health agencies by fifteen percent.
Summary: Incorporates the 2016 Healthcare Common Procedure Coding System changes to the Independent Audiology and Speech and Language Pathology fee schedule.
Summary: This SPA establishes a resource disregard to not count the cash surrender value of a life insurance policy worth less than ten thousand dollars in the determination of eligibility for institutionalized Medicaid applicants, provided that the individual is pursuing the surrender of the policy.
Summary: Clarifies the existing Disproportionate Share Hospital (DSH) payment within the state plaan confirming the annual Federal DSH allotment will bee fully expended each year.
Summary: To establish rates for outpatient services provided by public psychiatric hospitals and amend reimbursement methodology for public mental health clinics.
Summary: Amends attachment 4.19-B of the state plan to change the reimbursement methodology for electronconvulsive therapy (ECT) outpatient hospital services.
