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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 amendment reverses the 4.0% rate decrease that was applied to Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-IID) payment rates on July 1, 2016.
Summary: This amendment reverses the 4.00% rate decrease that was applied to fee-for-service inpatient hospital payment rates other than Diagnosis Related Group (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.
Summary: This amendment recognizes incurred medical or remedial care expenses as those that are incurred during the three months preceding the month of application.
Summary: This SPA proposes changes to comply with requirements of the Covered Outpatient Drug Final Rule with comment (CMS-2345-FC) (81 FR 5170) for drug reimbursement.
Summary: This amendment provides a mechanism for Federally Qualified Health Centers (FQHC) to be compensated for Long-Acting Reversible Contraceptives (LARCs) that are not included in the FQHC's rates
Summary: This amendment provides for a 4.00% reduction in provider payments for all services. Exceptions to the 4.00% reductions include Home and Community Based, Rural Health Clinic, Federally Qualified Health Center' s, Pharmacy, Limited Hospice, PACE, and Indian Health services.
