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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 SPA proposes to bring Indiana into compliance with the reimbursement requirements in the Covered Outpatient Drug final rule with comment (CMS-2345-FC).
Summary: This SPA is being submitted in order move Doula services from the other licensed provider section to the preventive services option and increasing the fee for those services.
Summary: This SPA moves the Modified Adjusted Gross Income (MAGI) eligibility determinations from the Oregon Health Authority to the Oregon Department of Human Services.
Summary: Permits physician assistants to individually enroll with theMedicaid program as a provider of services and revises reimbursement for physician assistant services to 75 percent of the physician fee schedule rate.
Summary: This SPA is being submitted to revise medical payment recovery thresholds from a fixed amount of $0 to the use of cost effectiveness to pursue based upon the claim amount.
Summary: Updates the ABP coverage limits for physical therapy, occupational therapy, and speech benefits to separate coverage limits for rehabilitative and habilitative services.
Summary: This SPA updates physical therapy, occupational therapy, and speech benefits to separate coverage limits for rehabilitative and habilitative services.
Summary: Removes the twelve week coverage limitation for tobacco cessation services and adds optometrists, clinical social workers, marital and family counselors, mental health counselors, and licensed clinical addiction counselors to the practitioners who may provide tobacco dependence counseling services.
Summary: Revises the reimbursement methodology for outpatient hospital services to make outpatient hospital payments at the aggregate level of reimbursement that would be paid under Medicare payment principles.
