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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: The plan amendment makes the state be able to comply with federal requirements of section 1902 of the Affordable Care Act regarding Freestanding Birth Center Services. The plan amendment does not have a direct Impact on Indians, Indian Health programs, or Urban Indian organizations.
Summary: The plan amendment establishes supplemental payments for emergency medical transportation services rendered by land and air ambulance providers. The amendment change does not have a direct impact on Indians, Indian Health Programs, or Urban Indian organizations.
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: The plan amendment clarifies the services and reimbursement methodology of substance abuse services covered under the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program to recipients under the age of 21. The plan amendment does not have a direct impact on Indians, Indian Health programs, or Urban Indian organizations.
Summary: The purpose of this amendment is to revise the reimbursement methodology for DSH payments to non-state distinct part psychiatric units that enter into a Cooperative Endeavor Agreement with the Department of Health and Hospitals Office of Behavioral Health.
Summary: The purpose of this SPA is to amend the reimbursement methodology for inpatient hospital payments to non-state distinct part psychiatric units that enter into a cooperative endeavor agreement with the Department of Health and Hospitals, Office of Behavioral Health.
Summary: The plan amendment carves out outpatient hospital services medical education payments from the prepaid risk-bearing MCO's so that the Medicaid agency can make the payments directly. The amendment does not have a direct impact on Indians, Indian Health programs, or Urban Indian organizations.
Summary: To continue medical education payments to state hospitals; children's spciialty hospitals and acute care hospitals classified as teaching hospitals when the hospitals are reimbursed by prepaid risk-bearing managed care origanizations for inpatient hospital services.
