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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: Amends the primary care reimbursement method outlined in section 1202 of the Affordable Care Act in order to utilize the site of service adjustment.
Summary: Incorporates into the State Plan guidance developed by the Department of Medical Assistance Services to aid preadmission screening for lcams in interpreting the Uniform Assessment Instrument when the applicant is younger than 21 years of age.
Summary: Reflect the revisions, effective for specified dates of service, to the list of vaccine product codes eligible for the primary care rate increase.
Summary: Removes the sunset date of September 30 2013 for Express Lane Eligibility option underMedicaid and to add language regarding eligibility determinations using Modified Adjusted Gross Income based methodology in accordance with the Affordable Care Act.
Summary: This amendment provides a payment incentive through the Quality and Efficiency Incentive Program to nursing facilities that voluntarily reduce bed capacity maintain compliance with all statewide nursing facilities licensing requirements and have no substantiated facility abuse within the preceding six month in order to increase quality efficiency and to improve statewide occupancy levels.
