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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: 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: 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: 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.
Summary: The State of New York is electing, as of May 1, 2012, the option to rely on a finding from an Express Lane agency (CHPlus) when determining whether a child satisfies one or more components of Medicaid eligibility. (Children's Health Insurance Program Reauthorization Act of 2009).
Summary: This amendment implements regulations for Provider Preventable Conditions (PPCs) and related payment adjustments for Medicaid and incorporates the CMS pre-print for PPCs for outpatient services into Attachment B. New York implemented the CMS pre-print for inpatient services in Attachment A under TN 11-046-A, approved on May 25, 2012.
Summary: This SPA will expand targeted case management services to Onondaga County to permit a nurse, who does not have a Bachelor's of Science in Nursing, but who is bilingual and enrolled in a Bachelor's degree program in nursing, to serve as a case manager to an underserved population.
