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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: State Plan Amendment (SPA) 23-0032 allows the Division of Medicaid (DOM) to update reimbursement of dental services provided in an ambulatory surgical center (ASC). For ASC dental services that do not have a fee on the Medicare ASC Fee Schedule, effective December 1, 2023, the SPA will allow ASC’s to be reimbursed at eighty percent (80%) of the Medicare rate that was in effect January 1, 2023, for the most comparable hospital outpatient service.
Summary: The purpose of this amendment is to allow the Division of Medicaid (DOM) to include beneficiaries diagnosed with hemophilia in the MississippiCAN program.
Summary: To implement a 7% rate increase for Rehabilitative services offered in community-based group homes for children and youth with intellectual/ developmental disabilities.
Summary: This SPA allows the Division of Medicaid (DOM) to increase the reimbursement rates for certain mental health services by 15.8% with half of the increase implemented in State Fiscal Year (SFY) 2024 and the second half of the increase implemented in SFY 2025. Rates are effective for services provided on or after July 1 for each year.
Summary: We have reviewed the proposed Rhode Island State Plan Amendment (SPA) to Attachment 4.19- B, RI-23-0007, which was submitted to the Centers for Medicare & Medicaid Services (CMS) on August 15, 2023 to extend a temporary rate increase to providers of First Connections services to increase Children's Group home rate.
Summary: This amendment is to extend its current waiver from seeking a RAC vendor approved in State Plan Amendment (SPA) 22-0024 for one (1) additional year to attempt to procure a new, competitively bid RAC contract that complies with current state and federal laws and regulations.
