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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 makes technical and editorial changes and differentiate the reimbursement methodologies of hemodialysis and peritoneal dialysis treatments.
Summary: Reduces the budget adjustment factor used in setting nursing home rates andadds a provision the limits rates from dropping below the last rate paid in SFY 2012.
Summary: Adds coverage for behavior analysis services by providing highly structured interventions with the goal of targeting and decreasing maladaptive behavior for recipients under the age of 21 years for whom behavior analysis services are recommended by a licensed physician.
Summary: Clarifies that lawfully residing children may receive Medicaid and CHIP coverage and will no longer be subject to a five year waiting period as provided under section 214 of the Children's Health Insurance Program Reauthorization Act off 2009 (CHIPRA).
Summary: Removes specific geographic references as the state will phase in additional counties in accordance with Section 1945 of the Act and state specific criteria.
