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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 amendment proposes to consolidate Registered Nurse (RN) and Licensed Practical Nurse (LPN) services into one consolidated nursing service and revises policy for reimbursement to family members under the Early and Periodic Screening Diagnosis and Treatment (EPSDT) benefit.
Summary: This amendment proposes to increase rates and service limits for two autism spectrum disorder (ASD) services and add two additional codes with service description to the ASD Services Manual.
Summary: This Supplemental Teaching Physician (STP) Payment Program state plan amendment updates the base year used to determine payments under the Average Commercial Rate (ACR) method.
Summary: Establishes compliance with the mandatory coverage and reimbursement of routine patient costs furnished concerning participation in qualifying clinical trials under Section 1905(gg) of the Social Security Act.
Summary: This amendment proposed to adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Summary: This amendment updates methods and standards for establishing Medicaid Disproportionate Share Hospital (DSH)
payments to qualifying DSH hospitals using the FY ending 2021 base year cost reporting period to calculate interim DSH payments; updates the inflation rate used to trend the DSH base year cost to the end of the 2021 calendar year; updates swing bed and administrative day rates based upon the October 1, 2022, redetermination of nursing facility payment rates; and updates the statewide outpatient hospital fee schedule relating to Vagus Nerve Stimulation codes.
