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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: Proposes to update the reimbursement methodology for drugs procured through the 340B program to allow for claim-level identification of 340B drug
Summary: Revises the Inpatient Hospital Services reimbursement pages of the State Plan to increase the current Standard Dollar Amounts (SDAs) for rural hospitals and creates a new SDA add-on for children's hospitals
Summary: Updates to Professional Services fee schedule by utilizing the 2019 Medicare fees schedule as a basis for determining the Medicaid reimbursement.
