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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: 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.
Summary: This SPA exempts dental services and applicable ancillary services provided to beneficiaries of all ages from the 10% provider rate cut approved under Assembly Bill.
Summary: Modifies the cost report used for the Drug Medi-Cal Program and ensures the state-developed cost report is in a format that meets CMS's reimbursement requirements for cost-based methodology.
Summary: Provides Non-Designated Public Hospital Supplememental Fund Program inpatient hospital supplementall payment payments will continue to be made to eligible hospitals for the program year from July 1, 2015 to June 30, 2016.
Summary: Updates Year 3 Diagnosis Related Group payment parameters for general acute inpatient services provided by hospitals to include border hospitals, defined as those hospitals located outside of CA that are within 55 miles driving distance from the CA border, effective for inpatient services with the dates of admission on or after July 1, 2015.
