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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: Amends the provisions governing substance use disorders (SUD) services rendered to children and adults in order to: 1) reflect the coordinated system of care contractor moving from a non-risk to a full risk capitated contract, 2) clarify the exclusion criteria for institutions for mental disease; and 3) clarify the requirements for residential addiction treatment facilities.
Summary: This SPA amend the provisions governing therapeutic group homes (TGH) in order to reflect the coordinated system of care (CSoC) contractor moving from a non-risk contract to a full-risk capitated contract and to reflect that TGH are carved out of management by the CSoC contractor to align with current practice and contract requirements.
Summary: Extend the period of transitional rates for one large Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) that provide continuous nursing coverage to medically fragile populations for an additional two years.
Summary: This amends the provisions governing the reimbursement methodology for rural health clinics (RHCs) in order to implement a payment methodology to allow reimbursement for long-acting reversible contraceptive devices outside of the perspective payment system rate.
Summary: This amends the provisions governing the reimbursement methodology for federally qualified health centers (FQHCs) in order to implement a payment methodology to allow reimbursement for long-acting reversible contraceptive devices outside of the perspective payment system rate.
Summary: This amends the provisions governing DSH payments for a major medical center in order to establish qualification criteria, and a DSH payment methodology for large private hospitals located in the southwestern area of the State (LDH Region 4), which provides specialized intensive care burn units.
