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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 updates changes in regulations. Section 2302 of the Patient Protection and Affordable Care Act was enacted on March 23, 2010, for the provision of Concurrent Care for Children. The Act allows children to continue to receive curative services for their terminal diagnosis, while still receiving hospice services. Children no longer must waive their rights to curative care to receive hospice care.
Summary: A proposed change to the reimbursement methodology for Rural Health Centers (RHC). This change includes a new alternative methodology for calculating encounter rates.
Summary: A proposed change to the reimbursement methodology for Federally Qualified Health Centers (FQHC). This change includes a new alternative methodology for calculating encounter rates.
Summary: Makes supplemental payments equal to the average commercial rate (ACR) minus regular physician payments for physician practices affiliated with publically-funded medical schools in the Tidewater area (Eastern Virginia Medical School).
Summary: This SPA discontinues the enrollment cap and change the rate methodology used for the Program of All-Inclusive Care for the Elderly (PACE) calculation of capitation rates for CY2013 for the state's program.
Summary: SPA will permit Virginia to participate in a three-year Demonstration that allows States to enroll individuals eligible for both Medicare and Medicaid ("dual eligibles") into managed care organizations that provide all Medicare and Medicaid benefits and supplementary services, through a seamless, integrated program.
