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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: Proposes to revise the state’s Medi-Cal Fee-For-Service (FFS) reimbursement methodology for blood factors in Hemophilia Treatment Centers, as described on Supplement 2 to Attachment 4.19-B, page 9, in the California Medicaid State Plan.
Summary: Allows the Department of Health Care Services to establish a supplemental payment program for Non-Emergency Medical Transportation (NEMT) services.
Summary: Extension of the time-limited supplemental payment for Freestanding Pediatric Subacute Facilities under the Medi-Cal program using California Healthcare, Research and Prevention Tobacco Tax Act.
Summary: The Quality Assurance Fee (QAF) program and reimbursement add-on for Ground Emergency Medical Transports (GEMT) provided by emergency medical transportation providers to Medi-Cal patients.