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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: Implements the provision of Section 1905(a)(28) of the Social Security Act regarding coverage and payment related to freestanding birth centers by indicating that there are no licensed or state approved freestanding birth centers in the state.
Summary: To clarify existing rehabilitative substance use disorder services and reimbursement methodology language currently described in the State Play by: defining the reimbursable unit of service; describing payment limitation; providing a reference to the provider qualifications per the State Plan; and publishing location to access State developed fee schedule rates.
Summary: Removes coverage and reimbursement methodology for the Personal Care Services option from the DE Medicaid State Plan as those services will now be delivered through the Home Health Services benefit.
Summary: To amend the State Plan to ensure compliance with federal law and regulations by updating the methods and standards language governing reimbursement methodology for home health services.
Summary: To amend the State Plan to amend Physical Therapy, Occupational Therapy, and Services for Individuals with Speech, Hearing and Language Disorders in order to establish coverage criteria, provider qualifications, service limitations and reimbursement methodology for Hippotherapy.
Summary: This SPA extends Medicaid coverage for an initial period of 12 months for low-income families who no longer qualify for Medicaid due to increased earned income or working hours from the caretaker relative's employment, or due to the loss of a time-limited earned income disregard.
Summary: This SPA proposes to implement presumptive eligibility conducted by hospitals in the Medicaid state plan in accordance with the Affordable Care Act.
Summary: This SPA defines the family size under MAGI methodology as counting a pregnant woman as one person when determining the family size of other individuals in the pregnant woman's household.
