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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 amendment updates the name of the designee that is authorized to submit state plan amendments for the South Carolina Department of Health and 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: Update Non-Emergency Medical Transportation (NEMT) services, and achieve compliance with the requirements for NEMT services under the broker model.
Summary: This amendment modifies the State's reimbursement methodology for setting payment rates for disproportionate share hospital services (DSH). Specifically, this amendment updates the base year used to estimate the interim DSH payments and inflates the rates to the rate year ending in 2015, increases the DSH limit for the out-of-state border hospitals eligible for DSH payment from 50% to 60%, continues any prior rate reductions implemented by the Department, and creates a $25.0 million DSH pool for rural hospitals and a $40.0 million DSH pool for hospitals identified as transformation hospitals.
Summary: Allows for eligibility for certain pregnant women and children as described in section 1903(v)(4) and 2107 (e)(1)(J) of the Social Security Act and who are otherwise eligible for assistance under the state plan (template S89).
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.
