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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 amendment will permanently extend existing provider increases for certain primary care services provided by qualified physicians. In addition, this SPA would extend the rate increase for the same services when provided by psychiatrists, obstetricians/gynecologists, and advanced practice registered nurses.
Summary: This SPA makes revisions to the reimbursement methodologies for the Short-Doyle/Medi-Cal acute inpatient services and Short-Doyle/Medi-Cal outpatient, rehabilitation, case management and other services.
Summary: This amendment will provide supplemental payments to eligible hospitals located within the District of Columbia that participate in the Medicaid program.
Summary: This SPA updates the Coordination of Benefits/Third Party Liability (COB/TPL) cost-effectiveness threshold amounts and makes adjustments to the trauma code editing protocols.
Summary: To provide technical updates for prosthetic and orthotic appliances and hearing aids to reflect that these appliances are covered when prescribed by a physician or other licensed practitioner, instead of physician or podiatrist.
Summary: Updates the Private Hospital Supplemental Fund Program Inpatient hospital supplemental payments for the program years from July 1, 2015 to June 30, 2018.
