An official website of the United States government
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
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 extends enhanced reimbursement rates for certain primary care physician services established under Section 1202 of the Affordable Care Act to the period of January 1, 2015 through June 30, 2016.
Summary: To update the following hospital inpatient services effective July 1, 2016: 1) Transition from V.32 to V.33 of the 3M Health Information System Hospital Inpatient APR-DRG Grouper, 2) Transition from V.32 to V.33 of the 3M Health Information System Hospital Inpatient Hospital Acquired Conditions Utility, 3) Update Appendix B "Out-of-State Hospital Transplant Services' Care Rates Effective July 1, 2016," to the most recent amounts as published by Milliman, and 4) Update Sections 2-1F. "Cost Reporting, What to Submit" and 2-1.H.5 "Provider Notification" to clarify that fee-for-service and coordinated care organization (CCO) Medicaid settlement data must be combined and reported on cost reports and that failure to provide cost report information will result in a provider's average cost-to-charge ratio for the bed class in which the hospital falls.
Summary: Clarifies the Medicare Ambulatory Payment Classification used to compute the observation code G0378 fee and the Medicare Average Sales Price drug pricing file used to compute chemotherapy drug code fees effective July 1, 2016.
Summary: Reimburses certain eligible obstetricians and gynecologists for the provision of certain primary care services at one hundred percent of the Medicare Physician fee schedule or at the MS regional maximum vaccine administration fee set by the Vaccines for Children program.
Summary: To clarify the definition of a change in the scope of services and the procedure for submitting a request for a rate adjustment due to a change in scope of service effective May 1, 2016.
Summary: To clarify the definition of a change in the scope of services and the procedure for submitting a request for a rate adjustment due to a change in scope of service effective May 1, 2016.
Summary: Requests a one year exception to 42 CFR 455.502(b) contracting with Recovery Audit Contractor and expands the duties of the current Medicaid Integrity Contractor
Summary: Implements the provision of Section 1905(a)(28) of the Social Security Act regarding coverage and payment related to freestanding birth centers by indicating that there are no licensed or state approved freestanding birth centers in the state.
