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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 managed care for physical and basic behavioral health in order to transition behavioral health services from administration by a single statewide management organization to an integrated behavioral and physical health model which will be administered by the five Bayou Health managed care organizations.
Summary: Amends the reimbursement methodology for physician services in order to increase the reimbursement rate paid to physicians for the administration of the drug, 17 Hydroxyprogesterone.
Summary: Provisions for governing coordinated care network and Medicaid managed care in order to change the name and to incorporate programmatic changes resulting from the inclusion of basic behavioral health services in the program and the voluntary enrollment of Medicaid eligible children identified in the Melanie Chisholm.
Summary: This SPA amends the inpatient hospital methodology by diminating the additional reimbursement for hemophilia blood products purchased by non-rural non-state acute care hospitals.
Summary: Amends the methodology for Disproportionate Share for Hospitals by diminating the mental health emergency room extensions pool payments for non-state acute care hospitals.
Summary: This SPA allows an add-on flat fee payment to the per diem for complex care for Medicaid recipients in private and non-state Intermediate Care Facilities for Individuals with Intellectual Disabilities.
Summary: Increases the transitional Medicaid per diem rate in effect on September 30, 2014, by $1.85, for Intermediate Care Facilities for Individuals with Intellectual Disabilities.
Summary: This SPA revises the provisions governing the reimbursement methodology for non-emergency medical transportation services to replace the monthly payment of capitated rates with a monthly per trip payment methodology.
Summary: This SPA reduces the amount of the state appropriation for the Disproportionate Share Hospital pool for federally mandated statutory hospitals from $2,000.000 to $1,000,000.
Summary: This SPA changes the provisions governing long-term personal care services to change the timeline for conducting re-assessments from annually to at least once every 18 months.
