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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: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to extend 1915(i) Housing Support Services, direct support worker supplemental payments, and 1915(i) Adult Day Health Program flexibilities.
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 update housing supportive services provider qualification criteria, provide reimbursement for retroactive provider rate changes, to increase the personal needs allowance, and to waiver pharmacy signature requirements.
Summary: This State Plan Amendment updates the definition of rural hospitals and revises the allocation methodology used to calculate hospital-specific DSH payments made on or after July 1, 2022.
Summary: This State Plan Amendment increases the per-diem reimbursement rate for both State Owned and Non State Owned Long-Term Acute Care Hospitals (LTAC) and Inpatient Rehabilitation Facilities (IRF) by 10%.
Summary: This State Plan Amendment adjusts base per diem rates for Psychiatric Residential Treatment Facility (PRTF) services rendered to persons under age 21 as follows: PRTFs will be reimbursed at provider-specific prospective rates based on the SFY 2020 or more recently available cost reports, including a 5% inflation factor and removing a cost cap provision. The per diem rate for children with a co-occurring diagnosis of autism will be at prospective rates based on 2020 or more recently available cost reports specific to service delivery of children with co-occurring diagnoses. The amendment also removes a utilization standard of 90% operation capacity.
Summary: This amendment seeks to add Behavioral Support Aides as a new service in the State of Georgia. This new service will provide in home behavioral support aides to children in the home and community-based setting.
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: This plan amendment authorizes the District of Columbia Medicaid Program to continue its authority beyond the public health emergency to permanently reimburse COVID-19 vaccines and COVID-19 vaccine administration at one hundred percent (100%) of the Medicare rates.
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.
