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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 changes the reimbursement methodology for brokered non-emergency transportation from fee for service to full risk capitation in thirteen (13) designated counties.
Summary: This amendment purposes to transition from the use of Medicare Severity Diagnosis Groups (MS-DRG) to the 3M All Patient Refined Diagnosis Related Groups (APR-DRG) for inpatient hospital reimbursement.
Summary: This state plan amendment revises the payment for Medicare Part B services for the dual eligible population to the Medicare allowable rate for specific ambulance transports.
Summary: This amendment changes the methodology for the distribution of Disproportionate Share Hospitals (DSH) reimbursements for specific categories of hospitals. Additionally, the amendment updates page for consistency and renumber lists.
Summary: The plan amendment updates the fee schedule for durable medical equipment prosthetics, orthotics, and supplies. The plan amendment does not have a direct impact on Indians, Indian Health programs or Urban Indian organizations.
Summary: The plan amendment updates the physicians and other practitioners' fee schedule. The plan amendment does not have a direct impact on Indians, Indian Health programs, or Urban Indian organizations.
Summary: This amendment updates the administrative practices, definitions, and procedures for State and Non-State Disproportionate Share Hospitals (DSH).
