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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 updates payment methodology for Programs of all Inclusive Care for the Elderly (PACE) due to TennCare implementing a Medicaid Managed Long-term Care model, and changes the standard used in calculating a PACE enrollee's Personal Needs Allowance (PNA).
Summary: Indicates that Published Rate is Paid for Up to 5 Visits Per Recipient in AHCCCS-registered facilities that provide covered services to Medicaid in an Indian Health Service or tribal 638 Facility.
Summary: Implements an Asset Verification System as part of the Medicaid eligibility determination and recipients. Defines the requirements of the Asset Verification System.
Summary: Assures that Arizona complies with the process of screening and enrolling providers and suppliers for the Medicaid program in accordance with Section 6401 of the Affordable Care Act, the Provider Screening and Other Enrollment Requirements Under Medicare, Medicaid,and CHIP.
Summary: This SPA revise the payment methodology for inpatient and outpatient hospital services and other outpatient services for surgical procedures. Specifically, the amendment proposes to deny payment for Provider Preventable conditions (PPC).
Summary: This SPA proposes to limit coverage for certain sedative hypnotic and opioid detoxification drugs for beneficiaries aged twenty-one years and older.
Summary: This SPA clarifies the service descriptions and provider qualifications for behavioral health services provided under the rehabilitation services component of the State Plan.
