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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: Reduces the reimbursement rates for services provided by end stage renal disease facilities, and to reduce the reimbursement for laboratory and radiology services by 3.5% due to a budget shortfall.
Summary: Reduces the reimbursement rates for non-rural, non-state inpatient hospitals and children's specialty hospitals in order to avoid a budget deficit.
Summary: This amendment revises the methodology used to calculate payment rates for inpatient hospital services. Specifically, it modifies the acute inpatient hospital reimbursement methodology for hospital rate year (RY) 2010. In addition, it allows a one-time supplemental payment of $5 .9 million to qualified providers.
Summary: This amendment clarifies that hearing instrument specialist services are provided as other licensed practitioner services pursuant to 42 CFR 440.60 and updates the State plan to reflect the State's new hearing aid replacement policy.
Summary: Exempts urgent care facilities and retail convenience clinics from the Primary Care Case Management requirement for written referral or authorization.
Summary: This amendment complies with Section 1 15 of the Medicare Improvements for Patients and Providers Act of 2008, which requires States to exempt Medicare cost-sharing benefits paid under the Medicare Savings Programs (MSPs) from estate recovery under section 191 7(b)(l) of the Act.
