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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 aligns the populations authorized through the State Plan versus 1115 waiver to include pregnant women eligible under 42 CFR 436.116, children eligible under 42 CFR 425.117 and 42 CFR 435.118, and presumptively eligible pregnant women.
Summary: This SPA makes changes to the State Plan to document the State's Collection of Federal Medical Assistance Percentages (FMAP) funds available for expenditures for medical assistance furnished to individuals enrolled in the new adult group created by the Affordable Care Act.
Summary: Extends the nursing facility quality assessment fee enhanced reimbursement provisions through June 30, 2017, makes changes to direct care services and supplies, and makes changes to requirements for reporting when there is a nursing facility change in ownership.
Summary: This SPA extends a 5% reduction in Medicaid payments for Nursing Facility services and a 3% reduction in Medicaid payments for Intermediate Care Facilities for the Developmentally Disabled services. This SPA reduces the NF reduction at 3% and reduces the ICF/IID and CRF/DD reduction to 1%.
Summary: 1915(i) State Plan Home and Community-Based Services (HCBS), Behavioral and Primary Healthcare Coordination Services; and IN.02.001 - Amendment to 1915(b)(4) waiver, Adult Mental Health Habilitation and Behavioral and Primary Healthcare Coordination Services
Summary: Conversion to from 209(b) to 1634 status, adoption of optional ABD category to 100% FPL, and implementation of income disregards for the Medicare Savings Program to increase QMB to 150% FPL, SLMB to 170% FPL, and QI to 185% FPL.
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.
