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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: Tobacco Cessation Verification of Coverage for Tobacco Cessation for Pregnant Women as mandated in the Patient Protection and Affordable Care Act.
Summary: Modifies the rate methodology for the Programs for the All-Inclusive Care of the Elderly (PACE) aligning payment with the Oregon Health Authority's (OHA) performance-based reimbursements.
Summary: This SPA modifies the State's methods and standards for reimbursing inpatient hospital services. Specifically, this amendment continues a system of supplemental payments to private and non-State government owned (NSGO) public acute care hospitals.
Summary: This SPA describes the methodology used by the state for determining the appropriate FMAP rates, including the increased FMAP rates, available under the provisions of the ACT for the medical assistance expenditures under the Medicaid program associated with enrollees in the new adult group adopted by the state.
Summary: This SPA reflects that an applicant or recipient must cooperate in identifying any third party who may be liable to pay for care under assignment of rights in the Medicaid state plan.
Summary: This SPA modifies Attachments 4.19-A and 4.19B of West Virginia's Title XIX State Plan. Specifically, SPA 12-010 implements regulations for provider preventable conditions and related payment adjustments for Medicaid.
