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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: The purpose of this SPA is to amend the provisions governing RHC service limits in order to remove the limits for Medicaid recipients 21 years of age and older.
Summary: Changes Provisions Governing Outpatient Hospital Services In Order to Remove the 12 Visits Per Year Limit on Physician Services Provided in a Clinic in an Outpatient Hospital Setting.
Summary: Amends the provisions governing therapeutic group homes in order to: revise the terminology to be consistent with current program operations and revises the reimbursement methodology to establish capitation payments to managed care organizations for children's services.
Summary: Changes the provisions governing school based health services in order to transition these services out of managed care and into the group of school based Medicaid services provided by Local Education Agencies.
Summary: This state plan amendment (SPA) revises the provisions governing FQHC service limits in order to remove the 12 visits per year limit for Medicaid recipients 21 years of age and older.
Summary: This state plan amendment (SPA) revises the provisions in the Professional Services Program governing physician services in order to remove the limits from outpatient physician visits.
Summary: To amend the inpatient hospital methodology to reinstate the additional reimbursement for hemophilia blood products purchased by non-rural non-state acute care hospitals.
Summary: To amend the provisions in the LA Medicaid State Plan governing Federally Facilitated Marketplace eligibility determinations to become an "assessment" state and only accept eligibility accessment from the FFM rather than accepting Medicaid eligibility determinations made by the FFM.
Summary: Changes the provisions governing school-based nursing services covered in the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Program to remove the Individualized Education Program (IEP) requirement.
