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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 transmitted an amendment to your approved Title XIX State Plan regarding physician reimbursement and the Physician Feedback and Incentive Award. Specifically, this SPA updates State Plan language to provide better details regarding physician reimbursement.
Summary: This SPA transmitted an amendment to your approved Title XIX State Plan regarding outpatient hospital reimbursements. Specifically, this SPA makes two technical changes to the State Plan: (1) to alter the data sources used to estimate prospective payments and (2) to correct the placement of language describing payment to hospital-based physicians which applies to both critical and non-critical access acute care hospitals.
Summary: Revises the application of sanctions and depreciation recapture. Revises the calculation of the direct care component to that it is based on resident-specific RUG rates.
