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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 governmental hospital supplemental payment program in Supplement 2 of Attachment 4.19-A by allowing for an interim payment and reconciliation process.
Summary: This amendment increases reimbursement for Intermediate Care Facilities for the Developmentally Disabled (ICF/DD); ICF/DD-Habilitative; and ICF/DD-Nursing.
Summary: This amendment, effective August 1, 2016, makes corrections to plan language on rate setting for Nursing Facilities - Level A; Distinct Part Nursing Facilities - Level B; and Distinct Part Nursing Facilities - Adult Subacute Units.
Summary: Implements the provision of Section 1905(a)(28) of the Social Security Act regarding coverage and payment related to freestanding birth centers by indicating that there are no licensed or state approved freestanding birth centers in the state.
Summary: Is an annual upate to the DDRG parameters, which includes updating the wage area neutrality adjustment, setting the labor share percentage for hospitals with a wage area index equal to or less than 1.00 to 62% and updating the Remote Rural and Statewide DRG BAse Price, Outlier Thresholds and Outlier Percentage Upper Bound, Discharge Status Values, and the DRG and HAC Grouper versions.
Summary: To extend the facility-specific rate setting methodology for freestanding skilled nursing facilities, including subacute care units of freestanding skilled nursing facilities, through July 31, 2020 and limits the maximum annual increase in the weighted average Med-Cal reimbursement rate for these facilities in the 2015/16 rate year to 3.62 from the previous year.
