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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 amendment makes revisions to the New York State Medicaid program, including changes to the coverage and reimbursement provisions for certain Medicaid services provided by health care facilities licensed by the New York State Department of Health, Office for People with Developmental Disabilities, Office of Mental Health and the Office of Alcoholism and Substance Abuse Services, and provides updates and revisions to the Ambulatory Patient Group methodology for freestanding clinic and ambulatory surgery center services.
Summary: Extends funding to the April 1, 2017 through March 31, 2020 period for certified home health agencies, AIDS home care providers and hospice service providers for the purpose of improving recruitment, training, and retention of home health aides or other personnel with direct patient care responsibility.
Summary: Continues for the period April 1, 2017 through March 31, 2019, various previously enacted cost containment measures identified in the SPA's language.
Summary: This State Plan Amendment amends the Community First Choice Option conflict of interest (COI) language invoking the geographical exemption to the COI requirements.
Summary: The SPA proposes to carve out the administration of the Long-Acting Reversible Contraceptive (LARC) from the APG reimbursement methodology when it is provided on the same Date of Service (DOS) as an abortion.
Summary: The SPA proposes to continue the elimination of the trend factor for non-institutional services, for the periods April 1,2015 through March 31, 2017.
