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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: Updates the ASC reduction factor to maintain budget neutrality in response to a Medicare rate change and clarifies OPPS language per companion letter dated June 22, 2015 for SPA 14-0016.
Summary: Corrects state plan language by reflecting a $3,500,000 payment as approved with SPA 13-04. In 2014, two SPAs were approved about the same time that modified the same page. The final version should have reflected the $3.5 million, but instead reflected an earlier allocation. The issue was identified recently and CMS indicated this technical SPA should be submitted to correct language to reflect that previously approved.
Summary: Reflects language to further define the reimbursement methodology for evaluation and management services provided by attending physicians in the emergency department of a hospital.
