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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 State Plan Amendment (SPA) was submitted to request an exemption to the Recovery Audit Contractor requirement 455.508(b) requiring 1.0 FTE Medical Director.
Summary: This State Plan amendment establishes a timeline of a look back period for the State to review Third Party Liability claims. Specifically this amendment will allow the Kentucky Department for Medicaid Services to look back three (3) years for payment for any healthcare item or services submitted not later than three (3) years after the date such item or services were provided.
Summary: The purpose of this State Plan Amendment is to provide assurances that the State is in compliance with the screening and enrollment of providers pursuant to 42 CFR 445.
Summary: This SPA implements new outpatient hospital reimbursement methodology which will, on an interim basis, be based on a facility specific outpatient cost-to-charge ratio based on the facility's most recently filed cost report.
