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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 freezes rates for SFY 2016 for inpatient hospital, long-term care facility, nursing facility, federally-qualified health care centers, and the infant learning targeted case management at SFY 2015 levels.
Summary: Adds Payment Methodologies for Certified Nurse Anesthetists, Physician Assistants, Community Health Aides III and IV, and Community Health Practitioners.
Summary: Uses the National Drug Acquisition Cost (NADAC) prices, as provided by the Centers for Medicare and Medicaid Services (CMS), as the state maximum allowable cost (SMAC) for both brand and generic drugs.
Summary: This transmittal updates the optional state supplement standards for special income level groups consistent with the published 2014 federal poverty levels.
