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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 transmitted a proposed amendment to your Agency's approved Title XIX State plan to implement the Resource Based Relative Value System (RBRVS) as a reimbursement methodology for certain providers of services within the State's Medicaid fee schedules.
Summary: This SPA transmitted a proposed amendment to your Agency's approved Title XIX State plan to update the current name of the head of the single State agency that has the authority to submit the Medicaid State plan or plan amendments.
Summary: This SPA transmitted a proposed amendment to your approved Title XIX State plan to provide an assurance that the State shall not make any payments for items or services provided under the State plan or under a waiver to any financial institution or entity located outside of the United States.
Summary: This state plan amendment is to memorialize the State of Nevadas tribal consultation process as extracted from the document Tribal Consultation Process Nevada Department of Health and Human Services (NDHHS) and the Indian Tribes in the State of Nevada. The consultation process has been in effect since March 2010. The effective date of the state plan amendment is October 1, 2010 based upon guidance from the Centers from Medicare and Medicaid Services (CMS). ln addition, CMS requires the consultation process to be added under the authority of the Medical Care Advisory Committee (MCAC).
Summary: This SPA transmitted a proposed amendment to your Agency's approved Title XIX State plan to update the organizational structure of the single State agency. Specifically, you proposed to update the departments within the Agency of Human Services and the Attorney General's certification.
Summary: SPA Establishes a Recovery Audit Contracotr (RAC) program to contract with one or more Medicaid contractors for the purpose of identifying upderpayments and overpyaments of Medicaid claims.
Summary: This SPA transmitted a proposed amendment to your approved Title XIX State plan to indicate that you will establish a Medicaid Recovery Audit Contractor (RAC) program as required by Federal Medicaid law.
Summary: This SPA transmitted a proposed amendment to your Agency's approved Title XIX State plan to modify the Vermont Drug Utilization Review (DUR) Board's membership requirements, duties, and responsibilities.
