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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 prvisions govering the reimbursement methodology for nursing facilities in order to reduce the per diem rates paid to non-state nursing facilities. The per diem rate shall be reduced by $90.26 of the rate in effect on June 30, 2014 until such time that the rate is rebased. The net effect is an increase in the per diem rates.
Summary: The SPA proposes to amend the provisions governing the reimbursement methodology for laboratory and radiology services to adopt a manual pricing payment methodology for covered services that do not have Medicare established rates.
Summary: The SPA proposes to amend the provisions governing the reimbursement methodology for physician services to adopt a manual pricing methodology for covered services that do not have Medicare established rates.
Summary: This SPA amends the provisions governing Early and Periodic Screening and Treatment EPSDT personal care services in order to revise the recipient qualification to remove the criteria regarding personal/caregivers availability in the home.
Summary: This State Plan Amendment (SPA) amends the provisions governing the reimbmsement methodology for physician services covered under the Louisiana Behavioral Health Partnership (LBHP) to exclude certain procedure codes from the January 2013 Medicare rate changes due to federal sequestration.
Summary: This amendment redefines the period of transitional rates from three to four years for public Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) that are transitioning to a private provider.
Summary: The SPA proposes to comply with the federal requirements of the Affordable Care Act with regards to hospice. The amendment also revises the provisions governing prior authorization for hospice services in order to control escalating costs associated with the hospice program.
Summary: The SPA proposes to adopt provisions to establish a new optional eligibility group under the Medicaid State Plan to provide coverage for family planning services and supplies to eligible men and non-pregnant women.
Summary: Establishes a New Optional Eligibility Group Under the Medicaid State Plan to Provide Coverage for Family Planning Services and Supplies to Eligible Men and Non-Pregnant Women.
