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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 amendment updates provisions of the Nursing Facility (NF) and Nursing Facility for Mental Health (NF-MH) Quality Care Assessment Pass-Through. The Pass-Through is begin changed from a lump-sum payment to a per diem add-on.
Summary: Updates provision of the Nursing Facility (NF) and Nursing Facility for Mental Health (NF-MH) Quality and Efficiency Incentive Factor per diem add-on. Also updates charts and exhibits within the State Plan that demonstrate the revised factors and limits applicable to the new rate period beginning with SFY 2014.
Summary: Incorporates into the State Plan guidance developed by the Department of Medical Assistance Services to aid preadmission screening for lcams in interpreting the Uniform Assessment Instrument when the applicant is younger than 21 years of age.
Summary: Reflect the revisions, effective for specified dates of service, to the list of vaccine product codes eligible for the primary care rate increase.
Summary: This amendment modifies the coverage and reimbursement of heart, heart-lung, and lung transplant services, as well as bariatric surgery services.
