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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 implement presumptive eligibility conducted by hospitals in the Medicaid state plan in accordance with the Affordable Care Act.
Summary: This SPA defines the family size under MAGI methodology as counting a pregnant woman as one person when determining the family size of other individuals in the pregnant woman's household.
Summary: Implement changes to the current reimbursement methodology for nursing facilities, psychiatric residential treatment facilities and intermediate care facilities for individuals with intellectual disabilities.
Summary: Provides supplemental payment for physicians and other professional services practitioners who are employed by a qualifying hospital for services rendered to Medicaid recipients in compliance with the Social Security Act.
Summary: Incorporates the Modified Adjusted Gross Income (MAGI) based eligibility process requirements, including the single streamlined application into the Medicaid state plan in accordance with the Affordable Care Act.
Summary: This SPA increases primary care provider payment for primary care services that was required by Section 1202 of the Affordable Care Act during 2013 and 2014.
Summary: This SPA increases the monthly income standards for Domiciliary Care to reflect the 1.7% SSI Cost of Living Adjustment increase from the Social Security Administration.
Summary: This amendment purposes to update the cost reporting periods used to calculate uninsured costs, updates the inpatient payment data used to calculate UPL distributions, and modify the UPL distribution methodology to eliminate an additional UPL payment previously paid to free-standing psychiatric hospitals.
