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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 plan amendment updates the reimbursement methodology for out-of-state nursing facilities to ensure continued access to nursing facilities for District Medicaid.
Summary: This amendment is to update the clinical trainees provider definition listed under Rehabilitative Mental Health Services, Targeted Case Management, Substance Use Disorder Treatment Services, Expanded Substance Use Disorder Treatment Services, and Medication-Assisted Treatment.
Summary: This plan amendment will permit the District of Columbia Medicaid program to reimburse public specialty inpatient hospitals at a rate that is fair and reasonable.
Summary: This plan amendment extends the Non-Designated Public Hospital Supplemental Fund program for the state fiscal year ending 2025, effective July 1, 2024.
Summary: Will permit the District of Columbia’s Medicaid Program to increase the personal needs allowance standard for eligible institutionalized long-term care residents and set annual increases tied to the federal Cost-Of-Living adjustment (COLA) published by the Social Security Administration.
