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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 transmittal updates the optional state supplement standards for special income level groups consistent with the published federal poverty levels.
Summary: This State plan amendment sought to describe the current reimbursement methodology for TCM, consistent with statutory and regulatory federal requirements.
Summary: This SPA proposes to bring Alaska into compliance with the reimbursement requirements in the Covered Outpatient Drug final rule with comment period (CMS-2345-FC).
Summary: This SPA modifies the reimbursement language of both the Community Health Provider services and transportation services to better reflect actual practice and the option for reimbursement at the state per diem, respectively.
Summary: This SPA proposes to bring Alabama into compliance with the reimbursement requirements in the Covered Outpatient Drug final rule with comment period (CMS-2345-FC).
Summary: This SPA removes the requirement that functional assessments be conducted in a consumer's home and also provides clarification on the two programs of Personal Care Services (agency-based and consumer- directed), and the provider qualifications for each.
Summary: This SPA proposes to revise the state plan to reimburse for inpatient and outpatient hospital services, also the state will continue to pay hospitals for services provided to Medicaid recipients for inpatient and outpatient services utilizing the reimbursement methods in effect on September 30, 2016.
Summary: This SPA updates reimbursement rates for inpatient psychiatric services for individuals under the age of 21, removes language restricting eligible providers to non-profits, removes language targeting individuals with a serious emotional disturbance for service eligibility, and corrects a previous error of placement of this reimbursement methodology in Attachment 4.19-8.
Summary: This SPA removes the section of the State Plan titled Telemedicine Applications, as telemedicine is not a1905(a) service but instead a service delivery method and it is not required on the plan page.
