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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: Prohibits Payments to States for any amounts expended for providing medical assistance for certain hospital outpatient and other PPC health care-acquired conditions for dates of service on or after July 1, 2011.
Summary: This SPA proposes to revise the payment methodology for inpatient hospital services. Specifically, the amendment proposes to deny payment for Provider Preventable conditions.
Summary: The amendment was submitted to appropriately set the rates for Ambulatory Surgical Centers (ASC) at 80 percent of the current Medicare Ambulatory Surgical Center Payment System. This methodology further allows the Division of Medicaid to update the ASC codes and rates annually based on the Medicare annual updates.
Summary: Revises the payment methodology for services provided by Nursing Facilities, Intermediate Care Facility for the Medically retarded and Psychiatric Residential Treatment Facilities.
Summary: Revise the payment methodology for services provided by Nursing Facilities, Intermediate Care Facilities for the Mentally Retarded and Psychiatric Residential Treatment Facilities.
