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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 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 sunsets provider type Certified Alcohol and Drug Counselor from qualified providers for certain outpatient psychotherapy over a period of two years.
Summary: The Oklahoma Title XIX State Plan has been amended to reflect the approved supplemental payment reimbursement methodology for Hospital Level 1 Trauma Outpatient Centers in the State Plan.
