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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 SPA is to remove Long Acting Reversible Contraceptives (LARC) from the Federally Qualified Health Centers (FQHC) PPSrate and reimburse the LARC under FFS.
Summary: This SPA is to remove Long Acting Reversible Contraceptives (LARC) from the Rural Health Centers (RHC) PPS rate and reimburse the LARC under FFS.
Summary: This amendment modifies Delaware's Alternative Benefit Plan (ABP) to update the base benchmark plan already in use to plan year 2014 from plan year 2012 and to align with the changes made to Delaware's Medicaid State Plan since ABP implementation.
Summary: This Amendment corrects the State plan regarding the state's payment of Medicare Part A and B deductibles and cost-sharing on Medicare crossover claims.
Summary: This amendment modifies the Modified Adjusted Gross Income (MAGI)-Based Eligibility Groups to add the Individuals Over 133% FPL and Under Age 65 group related specifically to an 1115 demonstration.
Summary: This amendment re bases Nursing Facility and Nursing Facility for Mental Health payment rates for State fiscal year 2018. Payment rates will increase on average by 4. 76 percent. This SPA also updates charts and exhibits within the State plan that demonstrate the revised factors and limits applicable to the rate period beginning with SFY 2018.
Summary: This amendment updates the plan to reflect the State's current policy of allowing inpatient hospital interim bills for inpatient hospital stays that exceed 30 days.
Summary: This amendment reverses the 4.0% rate decrease that was applied to fee-for-service inpatient hospital DRG outlier payment rates on July 1, 2016 for all hospitals other than critical access hospitals, hospitals located in frontier, rural and densely settled rural counties, and state-operated psychiatric hospitals.
