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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: update the reimbursement methodology for PACE. This SPA is also relocating the Medication Assisted Treatment pages from Supplement 3 to Attachment 3.1-A to Supplement 6 to Attachment 3.1-A.
Summary: Effective March 23, 2021, this amendment adds language to the Inpatient Hospital Reimbursement Methodology for Indirect Graduate Medical Education (IME) Payments for services outlined within the State Plan. This amendment has a fiscal impact with an expected increase of $168,393,723 in federal funds for federal fiscal year (FFY) 2020-2021 and an increase of $207,324,368 in federal funds for FFY 2021-2022.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to allow the territory to consider individuals absent from the territory to continue to be residents; to provide rate increases for FQHC medical encounters rendered at government quarantine locations; to create payment methodology for local non-government dialysis centers in AS during the PHE period; to revise the payment methodology for off-island dialysis; and to revise payment methodology for transportation and related accommodations associated with return from off-island medical care.
Summary: Effective July 1, 2020, this amendment adjusts reimbursement for Intermediate care facilities for individuals with developmental disabilities (ICF-IID).
