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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 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.
Summary: This amendment implements Section 112 of MIPPA, which increases the resource standards for QMBs, SLMBs and Qls to conform to the resources limits for individuals who qualify for Medicare Part D Low-Income Subsidy (LIS).
Summary: This amendment represents a complete rewrite of Attachment 4.19-D for ICF/MRs. and freezes ICF/MR per diem rates for SFY 2010 to the rates in place on June 30, 2009.
Summary: This amendment represents a complete rewrite of Attachment 4.19-D for nursing facilities (NFs), caps the NF per diem indirect care incentive payment at $9 .50, and reduces the NF inflation index adjustment from two-percent to one-percent.
Summary: This SPA makes technical corrections to identify how incontinence supplies are reimbursed which reflects current practice and aligns with the current Medicare Advantage contracts.
Summary: This amendment revises the reimbursement methodology for Partial Care services provided by other health professionals authorized to administer mental health clinic services.
Summary: This amendment implements the new option created by section 214 of the Children's Health Insurance Program Reauthorization Act of 2009 that permits States to extend federally-funded health insurance coverage to certain special status immigrant pregnant women and children.
Summary: This amendment modifies the payment methodology for a private Chronic Disease and Rehabilitation hospital that has no fewer than 500 licensed beds as of June 30, 2007. Specifically, it allows a 4.3 % increase in annual aggregate expenditures for per diem rate one (1) under section l(C))(l)(A).
