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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 freezes the case mix adjustment to the direct component of the nursing home daily rate to allow for updating the PDPM methodology.
Summary: This plan amendment assists hospitals by providing a temporary rate adjustment under the closure, merger, consolidation, acquisition, or restructuring of a health care provider.
Summary: This plan amendment provides for a two percent inflationary increase to the per diem rates for both Specialty-Acute and Rehabilitation hospitals.
Summary: This plan amendment reduces the capital component of the Medicaid rates for all residential health care facilities, excluding pediatric residential health care facilities, by 10%.
Summary: This plan amendment updates the plan by removing Medicare and other third party (non-Medicaid) ancillary costs from the allowable Medicaid reimbursement for Class I nursing facilities.
Summary: This plan amendment updates the plan by revising the Pay-For-Performance Supplemental Medicaid payment methodology to Class 1 nursing facilities from a per-diem add-on dollar amount to a flat per-diem multiplier methodology.
