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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: Revises the state plan to allow an incentive payment for coverage of private rooms in nursing facilities when specific facility criteria are met.
Summary: This plan amendment simplifies payment methodology for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) dispensed by a pharmacy.
Summary: This SPA updates Idaho's Basic Alternative Benefit Plan to update three existing benefits: Targeted Case Management for At-Risk Children; Community-Based Rehabilitation Services for Adults; and Community-Based Rehabilitation Services for Children.
Summary: This SPA revises Idaho's Enhanced Alternative Benefit Plan to update three existing benefits: Targeted Case Management for At-Risk Children; Community-Based Rehabilitation
Summary: This amendment is to amend its hospital presumptive eligibility SPA and presumptive eligibility program to include a performance standard for qualified entities or hospitals determining presumptive eligibility for pregnant women and/or children.
