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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 implement Section 2702 of the Affordable Care.Act of 2010 and the implementing final rule at 42 CFR 447, Subpart A.
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 amendment updates the methodology used to calculate payment rates for nursing facility services. Specifically it applies a total increase of $23.3 million to the current nursing facility user fee adjustment for fiscal year 2012 only; applies a total increaseof $3.7 million for an additional one-time add on payment based on each facility's user fee class; revises the determination of the Pediatric nursing facility rate based on 2006 cost reports instead of the most recently filed cost report; clarifies the criteria and documentation requirements for eligibility to receive P4P payments; and clarifies the provision for leave of absence days.
Summary: This SPA propose to include competitive bidding in the reimbursement method for incontinence supplies covered under the durable medical equipment (DME) benefit.
