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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: SPA provides qualifying criteria and methodology for rates for developmentally disabled clients that have high medical/high personal care needs.
Summary: Revises Title XIX state plan to update the payment methodology for out-of-state chronic disease or rehabilitation hospital outpatient services.
Summary: This SPA adds language regarding minimum data set on-site reviews and language regarding payment of therapeutic bed holds for certain facilities with residents who have a TBI diagnosis.
Summary: This amendment provides for a technical correction to add the reimbursement methodology for out of state (OOS) chronic disease and rehabilitation (CDR) hospital services to the state plan.
