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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 plan amendment adds an across-the-board adjustment of a 4.0% Cost of Living adjustment (COLA) to operating rates of payment, per the enacted 2024 Budget to the inpatient service Specialty Hospitals.
Summary: This SPA amends the State Plan for coverage of drugs authorized for import by the Food and Drug Administration when medically necessary during drug shortages.
Summary: This plan amendment adds a Cost-of-Living Adjustment (COLA) to support a five-point four percent (5.4%) increase to Specialty Hospital operating rates of payment until such time as the COLA increase is reflected in the base period cost reports.
Summary: This plan amendment continues temporary rate adjustments to long term care providers that are undergoing closure, merger, consolidation, acquisition or restructuring themselves or other health care providers.
Summary: This plan amendment adds a 1% increase to operating components of inpatient rates of reimbursement for hospitals certified under Article 28 of the Public Health Law, as well as out-of-state acute care hospitals, for dates of services on or after April 1, 2022.
Summary: This amendment will allow the District to provide assurance of compliance with mandatory annual My Health GPS Health Home reporting of the Core Set of Children's Health Care Quality Measures and the behavioral health measures on the Core Set of Adult Health Care Quality Measures for Medicaid.
Summary: This amendment will allow the District to provide assurance of compliance with mandatory annual state reporting of the My DC Health Home's Core Set of Children's Health Care Quality Measures and the behavioral health measures on the Core Set of Adult Health Care Quality Measures for Medicaid.
