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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 State Plan Amendment revises Disproportionate Share Hospital (DSH) methodology by increasing the allocation for hospitals receiving direct payment program (DPP) rate adjustments by the amount of the intergovernmental transfers (IGT) or certified public expenditures (CPE) on behalf of the hospital. The amendment also revises the definition of individuals eligible for inclusion in the DSH calculation for uncompensated care (UCC). This change eliminates the Medicare/Medicaid crossover dual-eligible population as well as the Medicaid secondary payor population from the UCC calculation and limits eligible individuals to (1) those who are eligible for medical assistance under the State Plan or under a waiver of such plan for whom the State plan or waiver is the primary payor for such services or (2) those who have no health insurance or other source of third-party coverage.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to adopt the third amendment to the Public Readiness and Emergency Preparedness (PREP) Act which covers the Advisory Committee on Immunization Practices (ACIP) recommended vaccines for children ages three through 18 and indicate the state provides coverage of any drug or biological that is approved (or licensed) by the U.S. Food & Drug Administration (FDA)
or authorized by the FDA under an Emergency Use Authorization (EUA) to treat or prevent COVID-19, consistent with the applicable authorizations.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to Waive any signature for the dispensing of drugs during the Public Health Emergency through May 1, 2022.
Summary: This SPA provides Georgia with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: This amendment proposes to update the legal name of GA Medicaid’s medical management and utilization review vendor, remove the list of specific items and services deemed experimental or investigational, and correctly reflect the non-covered services and procedures.
Summary: This amendment clarified revisions to the inflation projection methodology for the Day Activity and Health Se1vices (DAHS), 1915 Home and Collllllunity-Based Se1vices-Adult Mental Health (HCBS-AMH), Inte1mediate Care Facilities for Individuals with an Intellectual Disability (ICF/IID), Nursing Facility (NF), and Primaiy
Home Cai·e (PHC) programs. A revision will also be made to the nursing wage inflation methodology, which will affect only the DAHS, HCBS-AMH, ICF/IID, and NF programs.
