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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 will authorize the District of Columbia to increase the per unit reimbursement rate for crisis/emergency service codes H2011 and H2011 HK.
Summary: Removes from the state plan the eligibility of former foster care youth under age 26 who were in foster care under the responsibility of another state, and enrolled in Medicaid at the time they turned 18 or aged out of the foster care system in the other state.
Summary: Implements a price-based prospective payment system for nursing facility services and a quality improvement program with an optional QI payment program.
Summary: This SPA adds coverage of Autism Spectrum Disorder (ASD) services, and enrollment and reimbursement of Board Certified Behavior Analysts for providing ASD services.
Summary: This SPA will increase certain medical service codes to 100% of the Calendar Year 2014 Medicare fee schedule for attested primary care physicians and physician extenders. This SPA was approved December 4, 2017.
Summary: This SPA proposes to allow the District to provide nursing services for technology-dependent beneficiaries who require more individualized and continuous care than is available from a visiting nurse under the Skilled Nursing Home Health Services benefit or routinely provided by the nursing staff of a hospital or skilled nursing facility.
Summary: Effective for deliveries occurring on and after July 1, 2017, an additional payment per newborn delivery will increase by $500 for hospitals in rural counties with populations less than 35,000.
Summary: This amendment proposes to extend provider eligibility for a one time incentive payment to support the development of care plans for Health Home beneficiaries, beginning July 1, 2017 and ending October 31, 2017.
