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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: Increases the eligibility level for full-scope Medicaid coverage for pregnant women from 60% of the Federal Poverty Level up to and including 109% of the Federal Poverity Level in CA's Medicaid State Plan.
Summary: Implement a new rate-setting reimbursement methodology for clinical laboratory or laboratory services that is more market-based and user the lowest amounts that other payers (excluding Medicare and Medicaid) are paying for similar clinical laboratory services.
Summary: Updates Year 3 Diagnosis Related Group payments parameters for general acute inpatient services provided by hospitals, effective for inpatient services with dates of admission on or after July 1, 2015.
Summary: This SPA removes references to Individualized Health Support Plans from its Targeted Case Management group for children with Individualized Education Plans and Individualized Family Service Plans.
Summary: Updates the annual pool amount available for the rate augmentation payment to be made to emergency air medical transportation (EMATA) providers in the 2014/15 rate year.
Summary: This SPA updates the pool amounts and makes some changes to the quality measures involved in the Quality and Accountability Supplemental Payment program for freestanding skilled nursing facilities.
