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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 will authorize the District of Columbia to increase the per unit reimbursement rate for crisis/emergency service codes H2011 and H2011 HK.
Summary: This State Plan amendment provides authority for a reimbursement methodology that includes a base rate found in the State's fee schedule and multiple optional enhancements that can increase that wage where described criteria are satisfied.
Summary: Implements a price-based prospective payment system for nursing facility services and a quality improvement program with an optional QI payment program.
Summary: Makes two revisions to nursing facilities reimbursement rates: l) phases out the Direct Care policy adjustor in increments of twenty-five (25%) percent; and2) implements a rate freeze for a twelve ( 12mths) months period.
Summary: This SPA proposes to allow the District to provide nursing services for technology-dependent beneficiaries who require more individualized and continuous care than is available from a visiting nurse under the Skilled Nursing Home Health Services benefit or routinely provided by the nursing staff of a hospital or skilled nursing facility.
Summary: This State Plan amendment provides a temporary waiver of certain RAC requirements imposed by Section 1902(a)( 42) of the Social Security Act effective 7/1/2017-6/30/2020.
Summary: Increases the inpatient hospital DRG base rate by the CMS Hospital Prospective Reimbursement Market Basket for the applicable period, as reported in the quarterly Healthcare Cost Review published by the IHS Market.
Summary: Removes the three specified DSH pools and pool payment amounts for all inpatient hospitals, state operated hospitals, and woman and infant specialty hospitals and consolidates them into Pool D for non-government and non-psychiatric hospitals licensed within the State of Rhode Island, whose Medical Assistance inpatient utilization rate exceed I.0%.
Summary: This amendment proposes to extend provider eligibility for a one time incentive payment to support the development of care plans for Health Home beneficiaries, beginning July 1, 2017 and ending October 31, 2017.
