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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: Updates the Private Hospital Supplemental Fund Program Inpatient hospital supplemental payments for the program years from July 1, 2015 to June 30, 2018.
Summary: Extends an additional year rate augmentation payments to emergency air medical transportation providers for services rendered in the 2015-2016 rate year.
Summary: Incorporates changes to state law from AB 1308 (Bonilla, 2013) which removes the physician supervision requirement for licensed midwives and allows licensed midwives to bill independently for services provided within the scope of their license, including those provided in Alternative Birth Centers as birth attendants.
Summary: Allows DRG hospitals to request the use of an alternative CCR in determining cost outlier DRG payments for the following rate year, rather than using the 2552-10 cost report.
Summary: This SPA adds Mendocino and Trinity counties to the list of geographic areas offering Targeted Case Management (TCM) services for the "Individuals in Jeopardy of Negative Health or Psycho - Social Outcomes " TCM group.
Summary: Adds an Industry Average Rate Methodology to determine an interim Medi-Cal payment rate for Local Governmental Agencies that are enrolling or re-enrolling in the Targeted Case Management program.
Summary: To add Mendocino County to the list of geographic areas offering Targeted Case Management services for the "individuals with a Communicable Disease" group.
Summary: Adds Alameda and Tuolumne counties to the list of geographic areas offering " Targeted Case Management services for the "Individuals at Risk of Institutionalization" group.
