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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: Updates the state's Resource Utilization Group (RUG) reimbursement system to version IV and Minimum Data Set (MDS) 3.0 to be consistent with Medicare. Additionally, the state made a technical correction to the state plan language to clarify that the state budget adjustment factor is30o/o, which was previously undefined as part of the methodology.
Summary: This amendment revises the fiscal year 2017 pool amounts for Disproportionate share hospital (DSH) and supplemental access payments for uncompensated care costs.
Summary: Removes the reimbursement page for peer support services because reimbursement for these services already falls under the category of rehabilitative mental health.
Summary: Updates and clarifies limitations in physician service coverage that include licensing, provision of services, physician procedures, and utilization criteria.
Summary: This State Plan Amendment implements a disregard from resources and income in regard to the UT Educational Savings Plan and eligibility determinations for certain groups.
Summary: This State Plan Amendment corrects the State Funds amount on the page because the original amount erroneously reflected the Total Funds amount.
Summary: Transmitted addition of a laboratory outpatient services co-payment of $3.00 for NH Premium Assistance Program participants above 100% of the federal poverty level (FPL).
