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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 SPA concerns the implementation of a Primary Care Medical Home through a voluntary PCCM authority to allow for Wyoming Medicaid to pay the PCCM entities a Per Member/Per Month case management fee for managing the health care needs in a primary care medical home setting and for reporting quality measures to the State, in addition to payments made on a FFS basis.
Summary: This Amendment allows a beneficiary under a long-term care insurance policy to receive a resource disregard equal to insurance benefit payments made to or on behalf of the individual.
Summary: This amendment updates and clarifies service limitations for residents in skilled nursing facilities who are both eligible and not eligible under the EPSDT program.
