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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 state plan amendment documents that the State has an eligibility system for data matching through the Public Assistance Reporting Information System (PARIS). This amendment meets a requirement of section 1903 (r) of the Social Security Act.
Summary: This state plan amendment revises the state plan language for provider qualifications in the 1915 (j) program to align with the States' current Medicaid policy for consumer directed services. The State removed the option to permit participants to hire legally liable relatives.
Summary: Implements 8% Rate Reduction, Modifies Calculation of Standard Dollar Amount (SDA), and reduces the percent used in computation of outlier payments for inpatient hospital services reimbursed under the diagnosis related group (DRG) prospective system.
Summary: The Patient Protection and Affordable Care Act (P.L 111-148) as Amended by the Health Care and Education Act of 2010 (P.L 11-152), Title II, Subtitle D, Section 2301 established care provided in free-standing birth centers as a mandatory Medical Service.
Summary: Updates Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Fee Schedules and Implements 10.5 Percent Average Reduction to Reimbursements Paid to Providers.
