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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: Modifies the Medicaid reimbursement methodology for physician services by revising the payment rate so that the aggregate Medicaid reimbursement to physicians is at least 75 percent of the Medicare reimbursement for the same service, in accordance with the Healthy Indiana Plan.
Summary: This SPA revises the State's Standard Alternative Benefit Plan (ABP) to add home health aide and home health part-time nursing prior authorization requirements.
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: Updates the terms upon which the state intends to collect supplemental rebates from drug manufacturers in order to authorize the state, at its option, to also include MassHealth member utilization through its MassHealth MCOs under an agreement.
Summary: Amendment proposes changes to the reimbursement methodology for privately-owned inpatient chronic disease and rehabilitation hospital services.
Summary: To implement a 2% reduction to the market basket procentage increase for hospice providers that are not in compliance with Medicare Quality reporting requirements established under section 1814(i)(5)(A)(i) of the Social Security Act.
Summary: Revises the State Plan to continue targeted case management benefits provided by the Department of Youth Services through a child's 22nd birthday.
