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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 plan amendment eliminates Medicaid eligibility to individuals formerly in other states' foster care systems who have turned age 18 or aged out of the foster care system.
Summary: Updates inpatient acute hospital (in-state & out-of-state) base rates and revises the distribution methodology for High Public Payer Hospital supplemental payment to eligible hospitals. Additionally, a conditional l0% adjustment to be added to the Essential MassHealth Hospital supplemental payment.
Summary: Changes to the reimbursement methodology for private inpatient chronic disease and rehabilitation (CDR) hospital services. Specifically, it specifies rate year (RY) 2017 cost adjustment inflation factor of zero percent.
Summary: This plan amendment recognizes Licensed Birth Centers as providers in the New Mexico Medicaid Program for reimbursement, but does not include any payment for room and board.
Summary: This SPA revises the approved Title XIX State plan to add the newly distinguished provider type of Limited Services Clinics to the clinic services section of the state plan.
