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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 specifies cost adjustments for inflation to the Chronic Disease and Rehabilitation hospitals inpatient rate methodology. It also allows a reduction in the payment rate for administrative Day and an update to Per Diem Rate two (2) for private non-acute hospitals that had no fewer than five hundred (500) licensed beds as of June 30, 2007.
Summary: This amendment modifies the reimbursement methodology to North Dakota'sIntermediate Care Facilities for the Mentally Retarded (ICF/MRs) by amending the supplemental payment to providers who serve behaviorally challenging or medically fragile individuals whose needs exceed normal thresholds based on criteria established by the department.
Summary: This amendment revises the methodology used to calculate payment rates for inpatient hospital services. Specifically, it modifies the acute inpatient hospital reimbursement methodology for hospital rate year (RY) 2010. In addition, it allows a one-time supplemental payment of $5 .9 million to qualified providers.
Summary: This amendment clarifies that hearing instrument specialist services are provided as other licensed practitioner services pursuant to 42 CFR 440.60 and updates the State plan to reflect the State's new hearing aid replacement policy.
Summary: This amendment complies with Section 1 15 of the Medicare Improvements for Patients and Providers Act of 2008, which requires States to exempt Medicare cost-sharing benefits paid under the Medicare Savings Programs (MSPs) from estate recovery under section 191 7(b)(l) of the Act.
Summary: This amendment modifies the reimbursement methodology to North Dakota's nursing facility reimbursement section. Specifically, this amendment provides an exception to the application of the 90% occupancy limitation for specialized facilities providing services to individuals with traumatic brain injuries or geropsychiatric needs.
Summary: This amendment incorporates legislatively approved inflation factors and increases to the cost category limits for the 2010 and 2011 rates years; and, excludes noncovered bed hold and late charges from income offsets.
Summary: This amendment modifies the reimbursement methodology to North Dakota's nursing facility reimbursement section. Specifically, this amendment incorporates legislatively approved increases to the bad debt allowance and education costs.
