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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: Apply an overall negative inflationary adjustment of 4.16 percent for SFY 2010 and freeze rates for SFY 2011. This change is required due to the State administrative decision to freeze existing rates effective July 1, 2009 and effective October 1, 2009 to implement negative inflationary adjustments for SFY 2010.
Summary: Adjusts State Fiscal Year (SFY) 2010 and freezes SFY 2011 rates for case management services based on an overall program reduction of 9.807 percent for SFY 2010. SFY 2011 rates are frozen at the SFY 2010 amount.
Summary: Adjusts State Fiscal Year (SFY) 2010 rates for Rehabilitation Services based on an overall program reduction of 4.68 percent for SFY 2010. SFY 2011 rates are to be frozen at the SFY 2010 amount.
Summary: Will allow Medicaid to end new admissions to this service effective January 1, 2010 and remove this service from the State Plan effective July 1, 2010. This amendment will also remove the paraprofessional level of community support services and case management functions from the service.
Summary: Allows Medicaid to end new admissions to this service effective January 1, 2010 and remove this service from the State Plan effective July 1, 2010. This amendment will also remove the paraprofessional level of community support services and case management functions from the service.
Summary: Revises the rate setting methodology for ambulance providers. The ambulance fee schedule for all providers will be set at a percentage of Medicare. The government providers will be reconciled to cost.
Summary: This amendment adjusts State Fiscal Year (SF) 2010 rates for Local Education Agencies based on an overall program reduction of 9.00% for SFY 2010. SFY 2011 rates are to be frozen at the SFY 2010 amount.
Summary: This State plan change is to adjust SFY 2010 and SFY 2011 rates for extended services for pregnant women based on an overall program reduction of 9.76% for SFY 2010. SFY 2011 rates are frozen at the SFY 2010 amount.
Summary: Provides clarifying language in 4.19-B, Section 9, page 2 and adjusts SFY 2010 and freezes the SFY 2011 rates for Ambulatory Surgical Center based on an overall program reduction of 5.46 percent for SFY 2010.
Summary: Adjusts State Fiscal Year (SFY) 2010 and freezes the SFY 2011 rates for Physician Services, Independent Laboratories and Eyeglasses based on an overall program reduction of 4.90 percent for SFY 2010. SFY 2011, rates are frozen at the SFY 2010 amount.
