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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 SPA provides federally qualified health centers (FQHCs) and rural health centers (RHCs) with reimbursement for long acting reversiblecontraceptives (LARCs) and non-surgical trans-cervical permanent contraceptive devices outside of the encounter rate.
Summary: Implements an outpatient prospective payments system for Medicare prospective payment system hospitals. Under the outpatient prospective payments system, services will be reimbursed using ambulatory patient classifications.
Summary: Modifies Idaho's Healthy Connections Primary Care Case Management Program by creating a new tier-based case management fee structure with four distinct payment tiers that vary in amount and increase by tier based upon qualifying criteria.