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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 SPA authorizes supplemental add-on payments to the fee schedule rates for eligible ground emergency medical transports provided July 1, 2022 through June 30, 2023.
Summary: This SPA exempts specified providers from the reduction specified in paragraphs (6) through (13), set forth on pages 3.1 through 3.4 of Attachment 4.19-B. In addition, NEMT base rates and supplemental payments are adjusted to maintain reimbursement levels following their exemption from the reduction.
Summary: This amendment is to comply with federal requirements on premium and cost sharing tracking and assessing copays on non-emergency use of services provided in emergency departments. This amendment proposes to eliminate copayments in the Medi-Cal program effective July 1, 2022.
Summary: This SPA clarifies the use of Relative Value Units (RVUs) in Los Angeles County to apportion outpatient hospital costs to Medicaid in calculating the supplemental reimbursement for public outpatient hospital services.
Summary: This amendment is to update the income standards for Alaska’s optional state supplement program, the beneficiaries of which are eligible for Medicaid.
Summary: This amendment revises the reimbursement rate methodology for Intermediate Care Facilities for the Developmentally Disabled (ICF/DD), ICF/DD-Habilitative (ICF/DD-H), and ICF/DD-Nursing (ICF/DD-N).
Summary: This SPA amends the definition of a Targeted Case Management (TCM) encounter to include the provision of TCM services appropriately provided face-to-face, as well as through video synchronous and audio-only synchronous telehealth interactions.
