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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: Reduces the budget adjustment factor used in setting nursing home rates andadds a provision the limits rates from dropping below the last rate paid in SFY 2012.
Summary: Revises the provisions governing the tribal consultation process in the Medicaid program, specifically to clarify language pertaining to waiver amendments.
Summary: Amends the provisions governing Medicaid eligibility in order to return to a determination state and accept Medicaid eligibility determinations made by the Federally Facilitated Marketplace.
Summary: Removes specific geographic references as the state will phase in additional counties in accordance with Section 1945 of the Act and state specific criteria.
Summary: Amends provisions governing substance use services to update the terminology and service criteria; revises the provisions governing provider certification; and revises the reimbursement methodology for children's services to reflect the integration of specialized behavioral health services into Bayou Health by establishing a capitated rate for recipients enrolled in one of the managed care organizations.
Summary: Amends the provisions governing children's behavioral health services in order to narrow the statewide management's scope of service administration to coordinated system of care services only and to delegate provider certification functions to managed care organizations if the Department chooses.
Summary: Establishes provisions to use the Supplemental Nutritional Assistance Program (SNAP) option for the streamlined enrollment of SNAP recipients who meet the eligibility requirements for the new adult group under Medicaid expansion as authorized under the provisions of the Affordable Care Act.