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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 transmittal is being submitted to implement changes to prevent the payment of Provider Preventable Conditions. These are conditions that would have been reasonably avoided through the application of evidence-based practices.
Summary: This SPA propose to implement a process of screening providers and suppliers and create a temporary enrollment moratorium for certain providers under the Commonwealth of Virginia's Medicaid program, in accordance with Section 6401 of the Affordable Care Act.
Summary: This SPA implements comprehensive changes to the effective date related to fee-for service providers for the following services: Physicians' Services, Dental Services, Mental Health Services, Podiatry, Nurse-Midwife Services, Durable Medical Equipment, Local Health Services, Laboratory Services, Handling Lab Specimens, X-Ray Services, Optometry Services, Medical Supplies and Equipment, Home Health Services, Physical Therapy, Occupational Therapy, Speech Therapy, Clinic Services, Personal Assistance Services, Supplemental Physician Payments and Supplemental Payments to Non-State Government Clinics.
Summary: Which the State establishes supplemental payments for services provided by physicians at Virginia freestanding children's hospitals with greater than 50 percent Medicaid inpatient utilization in state fiscal year 2009 for furnished services provided on or after July 1, 2011. The SPA also eliminates the 4 percent reduction for all procedures set through the resource-based relative value scale (RBRVS) process effective for dates of service on or after July 1, 2011. Additionally, the SPA adds information for calculating the physician supplemental payment amounts using the Medicare equivalent of the average commercial rate (ACR) methodology prescribed by CMS.
Summary: This transmittal is being submitted to for technical corrections made when SPA approved prior to 11-14. This incorporates the language with appropriate dates.
Summary: This amendment implements concurrent care for children on hospice in compliance with Section 2302 of the Affordable Care Act. In addition, this amendment provides comprehensive coverage language on hospice services within the State plan in accordance with 1905(o) of the Social Security Act.
Summary: This transmittal is being submitted to reflect a new methodology to calculate the DSH payments to DSH hospitals and to describe the Upper Payment limit calculation.
