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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 modifies the methods and standards for making Medical Assistance payments to inpatient hospitals. Specifically, this SPA approximates a payment to the majority of hospitals at 98% of cost.
Summary: Continues supplemental hospital outpatient payment adjustments that increase the operating cost components of rates of payment for hospital outpatient and emergency department services for public hospitals, other than those operated by the State of New York or the State University of New York that are located in a city with a population of over one million people, for the period April 1, 2010 through March 31, 2011.
Summary: This SPA codifies a one year timely filing requirement for all providers enrolled in the District's Medicaid Program. This requirement will increase the timely filing period to one year (365 days), clarify the beginning of the timely filing period when a claim is filed for a service when the beneficiary's eligibility was determined retroactively, clarify the policy when an initial claim is submitted within the timely filing period, and afford providers the opportunity to appeal a timely claims filing requirement.
Summary: Reimbursement to private practicing podiatrists for podiatry services furnished to Medicaid eligible adults, age 21 and older, with a diagnosis of diabetes mellitus. (FMAP = 50%).
Summary: This amendment proposes that the capital cost component of the rate for eligible residential health care facilities shall be adjusted to reflect Medicaid's share of the costs of the annual debt service related to the financing of an automatic sprinkler system that will be in compliance with new federal regulations.
Summary: This SPA amends section 4.19 A of the District of Columbia's Title XIX state plan. Specifically, the amendment updates the Hospital for Sick Children's base year used in computing prospective payment rates.
Summary: New York State proposes to eliminate the expanded definition of "estate" and define the term "estate" to include all real and personal property and other assets included within an individual's estate and passing under the terms of a valid will or by intestacy.
