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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 adds supplemental payments for dental services provided by publicly owned dental providers under the Early and periodic Screening, Diagnosis and Treatment program. The amendment does not have a direct impact on Indians, Indian Health programs, or Urban Indian organizations.
Summary: The plan amendment is required by Section 6411 of the Affordable Care Act pertaining to Medicaid Recovery Audit Contractor (RC) program. There will not be a direct impact on tribes, therefore tribal consultation was not required.
Summary: This state plan amendment limits the payments for Medicare Part B services for the dual eligible population to no more than the state plan rate, with the exceptiom of renal dialysis services. The state plan amendmeut also changes the monthly capitation payment for Medicare Part C services to $10 per member per month.
Summary: The plan amendment implements a five percent reduction for physician services provided in tuberculosis clinics. The amendment change does not have a direct impact on Indians, Indian Health programs, or Urban Indian organizations.
Summary: The plan amendment clarifies language regarding requirements for providers of EPSDT audiology and case management services. The amendment change does not have a direct impact on Indians, Indian Health programs, or Urban Indian organizations.
Summary: The plan amendment updates the physician and other practitioners and tuberculosis clinic fee schedules. The amendment changes does not have a direct impact on Indians, Indian Health programs, or Urban Indian organizations.
