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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 specifies cost adjustments for inflation to the Chronic Disease and Rehabilitation hospitals inpatient rate methodology. It also allows a reduction in the payment rate for administrative Day and an update to Per Diem Rate two (2) for private non-acute hospitals that had no fewer than five hundred (500) licensed beds as of June 30, 2007.
Summary: Proposed amendment to your Agency's approved Title XIX State plan to (1) impose prior authorization requirements on high tech imaging, (2) limit the number of urine testing on a monthly basis; and (3) set limits and prior authorization requirements for physical, occupational and speech therapy services.
Summary: This SPA proposes to expand the delivery mode and set payment rates for certain Medicaid providers to render covered Medicaid services via telemedicine.
Summary: Transmitted a proposed amendment to your Agency's approved Title XIX State plan to update the organizational structure of the single State agency. Specifically, you proposed to (1) rename the Medicaid unit the Department of Vermont Health Access; and (2) elevate mental health to a department within the single State agency.
Summary: This SPA transmitted a proposed amendment to your approved Title XIX State plan to update coverage of targeted case management services provided to persons with developmental disabilities (1) who are unable to access needed medical, social, educational and other services because of adaptive deficits due to their level of disability, or (2) who lack the active assistance of a family member or other interested person to assist them in accessing needed services.
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: 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.
Summary: This amendment complies with Section 1 12 of Medicare Improvements for Patients and Providers Act (the "Act"), which amended section 1905(p)(l)(C) of the Act to make the resource limit for Qualified Medicare Beneficiaries (QMB), Specified Low-Income Medicare Beneficiaries (SLMB) and Qualified Individuals (QIs). conform to the resource limit for individuals who qualify for the full subsidy Medicare Part D low income subsidy.
