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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: To continue the suspension of the annual inflation factor to inpatient hospital and nursing facility rates for the 4th quarter of FFY 2013, FFS 2014 and the 1st, 2nd and 3rd quarters of FFY 2015.
Summary: This amendment clarifies coverage for Private Duty Nursing and will establish a monthly service limit that would be allowed in combination with the limit on home health services.
Summary: This amendment provides a 4% inflationary rate increase for Rural Health Clinics that enrolled as Medicaid providers before 12/31/12 to receive a one- time adjustment to their rate based on the 2013 Medicare cost report.
Summary: Update the levels of care for ambulatory behavioral health services with the American Society of Addiction Medicine (ASAM) and to update the annual limit of Medicaid-covered, outpatient ambulatory behavioral services.
Summary: This amendment updates the State plan to provide for a four percent inflationary rate increase for psychiatric residential treatment facilities (PRTFs).
Summary: Reflects Changes in Pharmacy Coverage Required by Section 175 of the Medicare Improvement for Patients and Providers Act of 2008 to Include Barbiturates "Used in the Treatment of Epilepsy, Cancer, or Chronic Mental Health Disorder" and Benzodiazepines in Part D Drug Coverage.
Summary: Conducts presumptive eligibility for individuals applying for coverage prior to January 1, 2014 and who needed coverage approved effective January 1 to ensure they had coverage in place.
Summary: Aligns Coverage of preventive services under the Medicaid State Plan with preventive services in Hawaii's approved ABP and allows for coverage of these services without cost sharing.
