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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: Revises Title XIX state plan to update the payment methodology for out-of-state chronic disease or rehabilitation hospital outpatient services.
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.
Summary: To increase reimbursement to primary care physicians by increasing the conversion factor used for primary care services payable under the RB RVS methodology.
Summary: Updates the reimbursement methodology for outpatient hospital services to remove separate billing for revenue codes 510-519 (clinic services), and to make a corresponding adjustment upward in the percentage of the OPPS rates that VT will pay to participating hospitals.
Summary: Updates the payment rates for personal care attendants, including provisions and overtime pay in accordance with the requirements of the Fair Labor Standards Act, and the accrual of earned sick time in accordance with Section 148C(d)(5) of M.G.L. Chapter 149.
