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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: Increases the overall outpatient rates for services provided in federally designated critical access hospitals (CAHs) by 5% and state designated CAHs by 3%.
Summary: Establishes a supplemental payment under the Upper Payment Limit using Medicare payment principles to reimburse Community Mental Health Center clinics.
Summary: Was in response to the companion letter issued with the approval of SPA 10-14. The companion letter had requested a number of revisions to the State Plan which were needed to bring the provision for targeted case management into compliance with current policy.
Summary: Amends MO HealthNet's reimbursement of outpatient radiology procedures to be reimbursed from a Medicaid fee schedule, effective for service dates beginning October 1, 2011, for all MO HealthNet enrolled hospitals. This amendment also provides a 5% increase to the prospective outpatient rate for federally-designated Critical Access Hospitals for service dates October 1, 2011 through June 30, 2012.
Summary: Which provides for smoking cessation program services covered for all participants who smoke when prescribed by a physician or health care professional with prescribing authority including smoking cessation products with behavioral intervention services provided by a wide range of healthcare provider specialties.
Summary: This ammendment provides the State Fiscal Year (SFY) 2012 trend factor; clarifies new federal audit and record retention requirements in accordance with federally mandated DSH audit standards; references new payment methodologies relating to Disproportionate Share (DSH) and Upper Payment Limit (UPL) payments; and revises when Enhanced Graduate Medical Education (GME) payments are paid to hospitals.
Summary: This amendment provides for a per diem increase to nonstate-operated ICF/MR facilities reimbursement rates by granting a trend adjustment of one and four tenths percent (1.4%) increase of the prospective rates effective for dates of service beginning October 1, 2011.
