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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: Adds requirements for accepting, managing, and completing requests for community-based and nursing facilities and using the electronic Preadmission Screening System.
Summary: This SPA proposes to permit individuals to use certified appraisals conducted by appraisers licensed by the Virginia Real Estate Appraiser Board as an alternative to the use of the tax assessed value to establish the value of any non-commercial real property for purposes of Medicaid resource eligibility.
Summary: Removes the requirement that PACE programs provide services through a coordination site that is licensed as an Adult Day Health Center by the Virginia Department of Social Services.
Summary: This SPA better defines and establishes the requirements of the Durable Medical Equipment program in order to reduce waste and inappropriately rendered services.
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.
Summary: This SPA replaces the existing DRG classification system for inpatient hospital services with a more refined grouper that recognizes the differences in severity of illness - the 3M APR-DRG.
