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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 allow the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act
Summary: Permits the District of Columbia Medicaid program to increase reimbursement rates for physical therapy, occupational therapy, and speech therapy services provided by home health agencies effective October 1, 2019
Summary: This amendment will authorize the District to reimburse the Medicaid RACs up to the highest contingency fee used under the Medicare RAC Program.
Summary: This amendment will allow the District to reimburse eligible governmental emergency ground transportation providers in accordance with the proposed cost-based methodology.
Summary: Allows the District to make supplemental payments in Fiscal Year 2020 to Medicaid- enrolled physician group practices that contract with a public, general hospital located in an economically underserved area of the District to provide at least two of the following services: inpatient, emergency department, or intensive care physician services.
Summary: This amendment will continue the District's ability to provide supplemental payments to eligible District hospitals that participate in the Medicaid program.
Summary: Clarifies hospice payment policy relative to intermediate care facilities for individuals with intellectual disabilities (ICF/IID), freestanding hospice inpatient facilities, nursing facilities, and inpatient care facilities.
