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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 proposes that in addition to payments for physician services specified elsewhere in the State Plan, the Department of Medical Assistance Services will make supplemental payments for physicians employed at a freestanding children's hospital serving children in Planning District 8 with more than 50 percent Medicaid inpatient utilization in fiscal year 2014.
Summary: Reduces the inflation factor for inpatient hospital services from 2% to 1% for FY 2017 and makes specialized nursing care reimbursement fully prospective.
Summary: To include activities, interventions, and goal directed trainings that are designed to restore functioning and that are defined in an individual service plan.
Summary: This SPA proposes to cover low dose computed tomography lung cancer screening annually for members between the ages 55-80 years, who are current smokers, have quit smoking within thelast 15 years, or have a history of at least one pack of cigarettes per day for 30 or more years.
Summary: This SPA proposes to establish a reconsideration process by which appellants can petition the Virginia Medicaid Agency's Director to reconsider the Department of Medical Assistance Services' (DMAS) Final Agency Decision. The SPA indicates that the DMAS Director's review shall be made upon the case record of the formal appeal. Testimony or documentary submissions that were not part of the formal appeal case record prior to the issuance of the Final Agency Decision shall not be considered.
Summary: Updates the general language and provider qualifications including requirements that all providers be certified by Virginia's Department of Behavioral Health and Developmental Services (DBHDS) as an intellectual disability case management agency.
Summary: Adds requirements for accepting, managing, and completing requests for community-based and nursing facilities and using the electronic Preadmission Screening System.
