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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 plan amendment updates the provisions governing qualifying criteria and reimbursement methodology for high Medicaid utilization academic hospitals in order to increase payments for inpatient hospital services.
Summary: The purpose of this SPA is to adopt provisions governing qualifying criteria and reimbursement methodology for high Medicaid utilization academic hospitals in order to increase payments for outpatient hospital services.
Summary: This SPA allows coverage of medically necessary prescribed drugs that are not covered outpatient drugs, including drugs authorized for import by the U.S. Food and Drug Administration (FDA) during drug shortages.
Summary: This SPA is to amend the provisions governing children’s and adult mental health services to expand the mental health professionals eligible to provide therapeutic services to include provisionally licensed professional counselors, provisionally licensed marriage and family therapists, and licensed master social workers.
Summary: This plan amendment will pay a $12 direct care add‐on to private (non-state) owned intermediate care facilities for individuals with intellectual disabilities (ICF/IID) for increased costs related to retaining and hiring direct care staff.
Summary: This plan amendment edits the provisions governing reimbursement for hospice services in order to ensure that the current payment methodology aligns with CMS requirements.
Summary: The proposed SPA would reimburse the LSU Dental Ambulatory Surgical Center providers (ASC) similar or equivalent rate to the outpatient hospital surgery fee schedule rate.
