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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 amendment was submitted to revise state plan language for specific state plan pages where references to "mentally retarded" are replaced with "individuals with intellectual disabilities."
Summary: This amendment was submitted in accordance with Section 214 of the Children's Health Insurance Program Reauthorization Act (CHIPRA), which permits States to cover certain children and pregnant women in both Medicaid and the Children's Health Insurance Program (CHIP) who are "lawfully residing in the United States" as described in section 1903(v)(4) and 2107(e)(l)(J) of the Social Security Act (the Act). Approval of this option resulted in a Federal budget impact of $1,546,729.00 for Federal Fiscal Year (FFY) 2018 and $4,891,174.00 for FFY 2019.
Summary: This amendment was submitted to establish a limit on the weekly amount of Medicaid funded speech therapy, occupational therapy, and physical therapy that are available to eligible beneficiaries, and to allow for extensions based on medical necessity.
Summary: This amendment was submitted to amend the state's Alternative Benefit Plan (ABP) to reflect changes in the method of determining medically frail.
Summary: This amendment proposes to change the reimbursement methodology for nursing facilities. The State will no longer pay a Provisional Rate after a nursing facility changes ownership. A cap was also added on the allowable professional liability insurance cost.
Summary: Changes to the basis for ingredient cost reimbursement to comply with requirements of the Covered Outpatient Drug Final Rule with comment (CMS-2345-FC) (81 FR 5170) pertaining to drug reimbursement in the Medicaid program.
Summary: Proposes for the aged, blind, and disabled medically needy group to disregard the amount by which an individual's Meedicare part B premium is reduced through enrollment in a Medicare Advantage Program.
