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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: Revise's Utah pharmacy reimbursement methodology to comply with the key provisions of the Covered Outpatient Drug Final Rule with Comment( 81 FR 5170) that was published in the Federal Register on February 1, 2016.
Summary: This SPA expands the staffing requirements for psychiatric facilities for individuals 65 or older to include at least one full-time board certified geriatric psychiatrist/geriatrician or one full-time board certified adult psychiatrist with a minimum of 3 years of experience caring for geriatric patients.
Summary: This state plan amendment resumes enhanced payments through the Alabama Medicaid Physician's Primary Care Enhanced Rates "Bump" Program for dates of service on or after October 1, 2016.
Summary: This SPA decreases the state's contingency fee rate for payments made to the Recovery Audit Contractor (RAC), and provides for an exception to 42 CFR 455.502(b), while it procures a new RAC vendor.
Summary: This amendment elects for the State to use Utah' s single streamlined application form for both Medicaid and Presumptive Eligibility (PE) effective January 1, 2016.
Summary: Revises the alternative single streamline paper application to include both hospital and pregnant women presumptive eligibility as well as includes revisions to the paper application for multiple human services programs effective January 1, 2016.
Summary: Reimburses recovery audit contractors on a flat-fee-basis rather than a contingency basis for the work of identifying over payments and underpayments in the Medicaid program.
