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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: Provides a Process Under Which the State Seeks Advice from Designees of Indian Health Programs and Urban Indian Organizations on State Plan Amendments, Waivers, and Proposal for Demonstration Projects that may Affect Indian Health, Indians, or Urban Indian Organizations.
Summary: Establishes a Recovery Audit Contractor (RAC) Program to Contract with one or more Medicaid Contractors for the purpose of Identifying Underpayments and Overpayments with Respect to All Services for Which Payment is Made to Any Entity Under Hawaii's State Plan or Approved Waiver.
Summary: This amendment revises the State's reimbursement methodology for setting payment rates for hospital services. Specifically, it will amend the plan language to revise inconsistent and ambiguous language and correct examples of the rate setting methodologies.
Summary: This amendment adds smoking cessation as a covered Medicaid benefit and expands current coverage of prescription and non-prescription tobacco cessation agents for the Medicaid eligible population.
Summary: This amendment revises the State's reimbursement methodology for setting payment rates for nursing facility services. Specifically, it will implement the Minimum Data Set (MDS) 3.0 to determine the case mix index used to establish payment rates. It also includes language clarifying that the cost of completing the MDS is an allowable cost to be included in determining the payment rates.
