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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: Revises the Ambulatory Patient Group methodology for hospital-based clinic and ambulatory surgery services, including emergency room services.
Summary: This increases the Medicaid payment for Medicare Part B Coinsurance claims for Independent Practitioner Services for Individuals with Developmental Disabilities (IPSIDD) and for freestanding clinic (Article 28) claims for the Traumatic Brain Injury (TBI) Waiver Population.
Summary: This updates the Department of Health professional dispensing fee (PDF) for brand name, generic and over-the-counter (OTC) outpatient drugs to align with current costs.
Summary: A revision for the Ambulatory Patient Group methodology for hospital-based clinic and ambulatory surgery services, including emergency room services, to reflect recalculated weights with component updates.
Summary: This extends the Ambulatory Patient Group methodology for hospital-based clinic and ambulatory surgery services, including emergency room services.
Summary: This extends the Ambulatory Patient Group methodology for hospital-based clinic and ambulatory surgery services, including emergency room services.
