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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: Providers an estimated one time enhanced payment for paid claim lines under the AmbulatoryPayment Classification methodology with the dates of service September 1, 2012 through December 3, 2012.
Summary: Incorporates mandatory and optional Modified Adjusted Gross Income based eligibility groups into the Medicaid state plan in accordance with the Affordable Care Act.
Summary: Implement the optional 1915 i state plan Home and Community Based Services benefitfor the elderly and disabled population with intellectual and developmental disabilities.
Summary: Continues coverage of pregnant minors under age 19 regardless of income who qualify under IV-E Adoption Assistance Children regardless of income.
Summary: Requests prior authorization for certain advanced imaging procedures except when performed during an inpatient hospitalization, an emergency room visit, or during a twenty-three hour observation period.
Summary: Changes in pharmacy coverage required by section 175 of the Medicare improvement for patients and providers ACT of 2008 which amended section 1860D-2(e)(2)(A) of the ACT to include barbiturates.
