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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 incorporates the 2015 HCPCS changes with pricing, to the following fee schedules; Ambulatory Surgical Centers, Family Planning Clinics, Medicaid Clinic, Mental Health and Substance Abuse Clinics, and Dialysis Clinics.
Summary: This purpose of this SPA adds KanCare Health Home - Serious Mental Illness to the additional covered benefits section, ABP 5, of the Alternative Benefit Plan.
Summary: This SPA proposes to eliminate coverage exclusions of "transexual surgery" and related services in the inpatient hospital and physician services section of the State Plan.
Summary: This amendment implements adjustments for Provider Preventable Conditions, consistent with Section 2702 of the Affordable Care Act of 2010 and the implementing final rule at 42 CFR 447 Subpart A.
Summary: This amendment proposes comprehensive changes to the reimbursement methodology for intermediate care facility for individuals with intellectual disability services from state owned and operated facilities.
Summary: This SPA revises reimbursement for physicians and other practitioners who bill using the physician, psychologist or behavioral health clinician fee schedules to establish a separate fee for procedures that have an established Medicare facility fee using the same percentage difference as Medicare for facility based services.