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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 amendment contains the Department's Private Coverage Option, through an ABP, for newly eligible adult beneficiaries ages 21 to 64, who are not determined to be medically frail.
Summary: This amendment contains the State's Health Plus Benefit Coverage through the Alternative Benefit Plan for newly eligible adult beneficiaries who are determined to be medically frail, newly eligible adult beneficiaries aged 19-20, and as an option for Medicaid beneficiaries with complex health needs in the Commonwealth.
Summary: This SPA proposes to remove the drug categories of barbiturates, benzodiazepines, and smoking cessation drugs from the list of drugs that may beexcluded or restricted from coverage from the State Plan effective January 1, 2014, in accordance with the provisions of section 2502 of the Affordable Care Act which amends section 1927(d)(2) of the Social Security Act (the Act).
Summary: This SPA continues Disproportionate Share Hospital payments to facilities designated as critical access hospitals and qualifying rural hospitals.
Summary: This SPA continues a supplemental payment to acute care general hospitals in Pennsylvania that provide a substantial portion of their inpatient services to Medicaid patients.
