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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: Sets reimbursement for services provided in a freestanding mental health facility at 91 percent of the Medicare rate for dates of service the participant is a resident of the facility.
Summary: This SPA replaces obsolete language pertaining to outpatient hospital reimbursement methodology used in State Fiscal Year 2015, replacing it with reimbursement methodology for state Fiscal Year 2016.
Summary: The State shall not provide any payments for items or services provided under the State plan or under a waiver to any financial institution or entity located outside of the United States.
Summary: This amendment removes obsolete language pertaining to supplemental payments for Intermediate Care Facilities for Individuals with intellectual disabilities fewer than 16 beds.
Summary: Permits Idaho to reimburse out-of-state intermediate care facilities for the intellectually disabled for treatment to Idaho's beneficiaries at the approved per diem rates of the home state's medicaid program.
Summary: This amendment revises the Medicare/Medicaid Coordinated Plan to comply with the requirements of the Affordable Care Act to ensure that the essential health benefits and other standards are met.
