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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: Adds a new provider type and reimbursement for prescribed pediatric extended care centers under early periodic screening, diagnosis and treatment EPSDT services.
Summary: Excludes certain amounts held in school-based savings accounts and interest earned on the accounts when determining eligibility for Medicaid for the elderly and people with disabilities (MEPD) and medically needy with spend down (MNSD) programs.
Summary: Aligns state plan language with the shift from a fee-for-service payment system to a managed care payment system by adjusting the underlying methodology and data sources for determining Program for All Inclusive Care for the Elderly reimbursement.
