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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: Removes the 20 mile radius restriction for telernedicine services provided by Federally Qualified Health Centers (FQHCs), Rural Health Centers (RHCs), Community MentalHealth Centers (CMHCs) and critical access hospitals. Provides reimbursement for telehealth services to horne health agencies.
Summary: Extension of the 5 percent rate reduction for services provided in outpatient hospital settings and end-stage renal disease clinics through December 31 2013E ffective January 1 2014 through June 30 2015 the rate reduction for outpatient hospitals will be decreased to 3 percent; Effective January 1, 2014, the rate reduction for end-stage renal disease clinics will be eliminated; and -Modifies the Hospital Assessment Fee Methodology.
Summary: This amendment proposes to revise the state plan to indicate that a physician may specify the necessity of a brand name drug by handwriting the words Brand Medically Necessary or words of similar meaning on the prescription.
Summary: Amendment extends the 5% reduction in Medicaid reimbursement for services in an inpatient hospital setting for the period of 7/1/13 through 12/31/13 and changes the reduction to 3% for the period of 1/1/14 through 6/30/15.
