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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 removes from the state plan the eligibility of former foster care youth under age 26 who were in foster care under the responsibility of another state, and enrolled in Medicaid at the time they turned 18 or aged out of the foster care system in the other state.
Summary: This amendment updates the tobacco cessation services sections of the state plan to provide for coverage of Food and Drug Administration (FDA) approved tobacco cessation medications and tobacco cessation services recommended by the U.S. Preventive Services Task Force.
Summary: This SPA revises the limits for physical, occupational, and speech therapy services to twenty (20) visits per therapy for rehabilitative services and twenty (20) visits for habilitative services.
Summary: This SPA establishes an Alternative Payment Methodology for Tribal 638 facilities that elect to be paid as Federally Qualified Health Centers (FQHCs).
Summary: This amendment updates All Patient Refined Diagnosis Related Group (APR-DRG) reimbursement for inpatient hospital services, effective January 1, 2018.
Summary: This SPA was submitted as a technical correction, revises the reimbursement methodology for critical access hospitals (CAHs). Specifically, this SPA allows reimbursement of 101% of cost for outpatient clinical laboratory services.
Summary: Updates the State Plan establishes differential adjusted payments for integrated clinics, physicians, physician's assistants, and registered nurse practitioners.
