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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 to suspend the Medicaid Recovery Audit Contractor Program, a requirement in section 1902(a)(42)(B)(i) of the Social Security Act, for a two-year period because ninety-seven percent of Medicaid beneficiaries participate in managed care.
Summary: To provide 12 months of continuous eligibility for children under age 19 in Medicaid. This amendment will align state policy and practices with federal requirements under section 5112 of the Consolidated Appropriations Act, 2023.
Summary: This amendment will allow the Alabama Medicaid Agency to apply the reimbursement basis for inpatient and outpatient hospital services for State fiscal year 2024.
Summary: This SPA continues New Jersey's graduate medical education subsidy supplemental payment at the same aggregate level as the prior fiscal year and updates the amount allocated to each qualifying hospital.
Summary: This SPA updates the individual provider payment allocations for the SFY 2024 Graduate Medical Education (GME) Supplemental Program and adds a method for redistributing overpayments.
Summary: To disregard refunds issued by the state to individuals who incurred Medicare-related premiums, deductibles, and co-payments as a result of not having been enrolled in the appropriate Medicare Savings Program eligibility group.