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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Summary: This amendment includes technical changes and removes outdated language pertaining to issuance of Medicaid eligibility cards to homeless individuals.
Summary: Children with SED will qualify for health home services whereas SED will be defined to include serious emotional disturbance, co-occurring developmental disability and mental illness, co-occurring mental health and substance abuse, or developmental Disability eligible (per NJ Statute 10:196) with symptomology of SED.
Summary: This SPA revise the APR-DRG from version 31 to version 32. In addition, the amendment proposes to: increase the base inpatient DRG rate paid to hospitals, provide for an additional add-on payment for trauma centers, adjust the outlier marginal cost percentage, and provides for additional funding for the Statewide Residency Program.
Summary: Removes outdated standards and incorporates the use of the American Academy of Pediatrics and Bright Futures Recommendations for Preventive Pediatric Health Care.
