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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 proposes to cease quarterly supplemental payments to qualifying private hospital partners of Type One hospitals for dates of service on or after October 1, 2018. This also proposes that effective October 1, 2018, supplemental payments will be issued to qualifying private hospitals for outpatient services provided to Medicaid patients.
Summary: This provides assurance that the state complies with statutory requirements in section 1906, Health Insurance Premium Payment (HIPP) program, and section 1906A, HIPP for Kids premium assistance program.
Summary: This describes the methodology used by the state for determining the appropriate FMAP rates, including the increased FMAP rates, available under the provisions of the Affordable Care Act applicable for the medical assistance expenditures under the Medicaid program associated with enrollees in the new adult group adopted by the state and described in Title 42 of the Code of Federal Regulations (CFR) §435.119.
Summary: This SPA sunsets the nursing facility bed reduction process as of June 30,2018, and sets the nursing facility reimbursement at the 62"d percentile of allowable costs for the period July l, 2018 to June 30, 2026.
Summary: This SPA proposes to permit residents of nursing facilities to deduct the costs of limited specific dental procedures from their payments towards the costs of their nursing facility care. Nursing facility residents shall be limited to deducting the following dental procedures: (i) routine exams and xrays, and dental cleansing twice yearly; (ii) full mouth x-rays once every three years; and (iii) deductions for extractions and fillings shall be permitted only if medically necessary as determined by the department.
Summary: This SPA replaces the current Level of Functioning (LOF) survey with the Virginia Individual Developmental Disabilities Eligibility Survey standards for individuals seeking Intermediate Care Facilities for Individuals with Intellectual Disabilities services. By using the VIDES standards for institutional care, the Commonwealth is restoring the consistency of applied functional standards for these individuals regardless of whether they obtain their care in the communities via a waiver or in ICF/IID institutions.
