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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: Update Non-Emergency Medical Transportation (NEMT) services, and achieve compliance with the requirements for NEMT services under the broker model.
Summary: This amendment modifies the State's reimbursement methodology for setting payment rates for disproportionate share hospital services (DSH). Specifically, this amendment updates the base year used to estimate the interim DSH payments and inflates the rates to the rate year ending in 2015, increases the DSH limit for the out-of-state border hospitals eligible for DSH payment from 50% to 60%, continues any prior rate reductions implemented by the Department, and creates a $25.0 million DSH pool for rural hospitals and a $40.0 million DSH pool for hospitals identified as transformation hospitals.
Summary: This SPA amends Idaho's Enhanced Alternative Benefit Plan (ABP) by adding endorsed/certified school psychologist as individuals who can provide supervision for Community-Based Rehabilitation Services (CBRS) providers.
Summary: This SPA amends Idaho's Basic Alternative Benefit Plan (ABP) by adding endorsed/certified school psychologist as individuals who can provide supervision for Community-Based Rehabilitation (CBRS) providers.
Summary: Allows for eligibility for certain pregnant women and children as described in section 1903(v)(4) and 2107 (e)(1)(J) of the Social Security Act and who are otherwise eligible for assistance under the state plan (template S89).
Summary: To continue complying with economy and efficiency as required by section 1902(a)(30) of the Social Security Act to an acceptable reimbursement methodology with regards to the Supplemental Teaching.
Summary: This SPA allows the exclusion of particular covered outpatient drugs, or class of drugs, from the managed care organization (MCO) model in those cases where they are not included in the MCO capitated rate.
