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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 SPA updates physical therapy, occupational therapy, and speech benefits to separate coverage limits for rehabilitative and habilitative services.
Summary: Extends the Ambulatory Patient Group (APG) methodology for freestanding clinics and ambulatory surgery center services from January 1, 2016 through December 31, 2017.
Summary: This amendment proposes to update the state Medicaid program' s drugs on which it may exclude from coverage or otherwise restrict in order to comply with the requirements of the 21' Century Cures Act.
Summary: To extend the NY Ambulatory Patient Group (APG) methodology for freestanding clinic and ambulatory surgery center services for the effective period January 1, 2015 through December 31, 2015.
Summary: Eliminates the two percent (2%) Across-the-Board reduction for payments made under the State's non-institutional State Plan. However, this SPA does not eliminate the 2% Across-the-Board reduction for services provided by freestanding clinic providers.
Summary: Proposes to continue a pay for performance quality incentive payment program for non-specialty nursing facilities and a related proportional rate reduction.
