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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: Provides for the implementation of an Asset Verification System for purposes of determining Medicaid eligibility for aged, blind, and disabled Medicaid applicant and recipients as required under 1940 of the Social Security Act.
Summary: This amendment modifies the methodology for the recoupment and redistribution of disproportionate share hospital overpayments identified through the annual DSH audits.
Summary: Adds presumptive eligibility for pregnant women to amend the requirements for determinations of PE for children and to amend the definition of a parent/caretaker relative.
Summary: Defines how GME is calculated for newly qualified hospitals, implements a zero inflation factor for nursing facility reimbursement for State Fiscal Year 2016 and amends the price-based PPS transition period for nursing facilities meeting certain bed and occupancy criteria.
