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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 is an amendment to rates for nursing facilities and establishes additional payment methodologies associated with COVID-19 supports and oversights for fiscal year 2021.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to add temporary rate increases for adult day health and day habilitation providers during the public health emergency. The Commonwealth proposes to change the unit rate from a 15 minute increment rate, to full day and partial day per diem rates.
Summary: Effective October 1, 2020, this amendment authorizes updates to the reimbursement methodology for acute inpatient hospital services for fiscal year (FY) 2021.
Summary: Effective February 1, 2021, this amends the current targeted case management state plan amendment for public health nurse home visiting to include three additional counties (Baker, Clatsop and Marion).
Summary: Effective 10/01/2020, this amendment updates the reimbursement methodology for privately owned chronic disease and rehabilitation inpatient hospital services for fiscal year (FY) 2021.
Summary: Effective 10/01/2020 this amendment updates the reimbursement methodology for privately owned psychiatric and substance use treatment hospital services for fiscal year (FY) 2021.
Summary: Effective 10/01/2020, this amendment updates the methods and standards used to revise the payment rates for acute outpatient psychiatric and substance abuse outpatient hospitals.
Summary: CMS is approving this time-limited state plan amendment to
respond to the COVID-19 national emergency. The purpose of this amendment is to increase certain payment rates and to allow additional providers the ability to order Home Health services including Durable Medical Equipment.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purposes of this amendment is to update Payment Methodologies for Certain Hospital, Community Health Centers, Physician, and coverage for mobile testing service done by EMTs during the COVID-19 Emergency period.
