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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: Implements a price-based prospective payment system for nursing facility services and a quality improvement program with an optional QI payment program.
Summary: This SPA removes the requirements for Home Health Agency providers to complete cost reports. Additionally, language was changed to bring the State Plan into compliance with 42 CFR 440.70 by not restricting HHA Services to only members who are homebound.
Summary: Makes conforming changes to the state plan to reclassifies nursing consulting services that are not directly related to the provision of hands-on-resident care from the administrative component to the indirect care component.
Summary: This state plan amendment makes changes to definitions and terminology in compliance with state law, removes the 20-mile restriction between patient and provider, and revises the permissible telemedicine provider and service types.
Summary: This state plan amendment modifies the reimbursement methodology for rehabilitative services to add reimbursement for opioid treatment program services.
Summary: This SPA proposes to allow the District to provide nursing services for technology-dependent beneficiaries who require more individualized and continuous care than is available from a visiting nurse under the Skilled Nursing Home Health Services benefit or routinely provided by the nursing staff of a hospital or skilled nursing facility.
Summary: This amendment proposes to extend provider eligibility for a one time incentive payment to support the development of care plans for Health Home beneficiaries, beginning July 1, 2017 and ending October 31, 2017.
