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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: Makes changes to the state plan to differentiate payments for routine home care based on length of stay and to implement a service intensity add-on payment.
Summary: This SPA permits states to require certain Medicaid Beneficiaries to share in the costs of providing medical assistance through premiums and cost sharing.
Summary: Modifies Reimbursement Methodology for Inpatient Hospital Services by Adopting the All Patient Refined (APR) Diagnosis Related Group (DRG) Grouper, Version 30 & Implementing Updated Inpatient DRG Relative Weights & Payment Rates.
Summary: This State Plan amendment makes conforming changes to the SPA to extend the current three percent (3%) rate reduction for nursing facilities that is currently set to expire on June 30, 2015. This rate reduction will be extended for the period July 1, 2015 through June 30, 2017.
Summary: This State Plan Amendment makes conforming changes to the SPA to extend the current three percent (3%) rate reduction for inpatient hospital services that is currently set to expire on June 30, 2015. This rate reduction will be extended for the period July 1, 2015 through June 30, 2017.
Summary: Increases Medicaid Reimbursement to Intermediate Care Facilities for Individuals with Intellectual Disabilities and Community Residential Facilities for the Developmentally Disabled by 3% from the Methodology in Effect on December 31, 2013.
