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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: Disregards all household income for non-Title IV-E adoption assistance children and 2101 (f)-like children who are covered as reasonable classifications of children under 42 CFR 435.222.
Summary: To exempt dental pediatric surgery centersfrom the provider payment reduction imposed by California Assembly Bill 97 provided that at least 95 percent of the Medi Cal beneficiaries they serve are under the age of 21.
Summary: Expands the scope of services offered under the State existing 1915i State plan section that serves persons with developmental disabilities that require a level of care that is less stringent than institutional criteria.
Summary: Provides Medi Cal providers that are qualifying 340B eligible covered entities and purchase drugs through the 340B drug pricing program to bill an amount not to exceed the entity's actual acquisition cost for the drug plus a professional fee for dispensing of 7dollars and twenty cents.
Summary: Increases the payment rate for specific drugs, categories of drugs and certain pharmacies andwould reverse in certain circumstances the ten percent payment reduction that was approved through SPA 11-009.
Summary: Incorporates the MAGI based eligibility process requirements, including the single streamlined application, into Wyoming state plan in accordance with the Affordable Care Act.
Summary: Expands the scope of physical occupational and speech therapy services offered to all Medi-Cal populations to include services aimed at the maintenance and acquisition of skills.
Summary: This amendment exempts distinct part nursing facility Level B located in rural and frontier areas from the current rate reduction effective September 1 2013 and exempts all other distinct part nursing facility Level B from the current ratereduction effective October 1 2013.
Summary: Introduce coverage for Optional Targeted Low-Income Children,to transition children from California Childrens Health Insurance Program to Medicaid, and to impose premium payments.
