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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 amendment increases the allowable cost of the provider tax that can be recognized for reimbursement purposes from $14.30 to $16.15 per day, for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID).
Summary: Removes Barbiturates, Benzodiazepines, and Agents Used to Promote Smoking Cessation From the List of Drugs the State Medicaid Program May Exclude From Coverage or Otherwise Restrict in Order to Comply with the Requirements of Section 2502(a) of the Affordable Care Act.
Summary: Proposes to amend the provisions governing Other Licensed Practitioners covered under the Medicaid State Plan in order to establish reimbursement for services rendered by licensed behavior analysts.
Summary: The SPA proposes to adopt provisions to include an optional coverage group under the Medicaid State Plan to implement the State Provisional Medicaid Program which will provide interim Medicaid-only benefits to eligible individuals until such time that a decision has been rendered on their SSI cash assistance application pending with the Social Security Administration as per 1902(a)(IO)(A)(ii)(X) and 1902(m)(l) of the Social Security Act.
Summary: Reduces the income limits, eliminates buy-in premiums and revises the eligibility criteria for the Medicaid Purchase Plan Program which provides coverage to workers with disabilities.
Summary: Revises the reimbursement methodology for rehab clinics in order to increase the rates for physical and occupational therapy services rendered to recipients under the age of 21.
Summary: Revises the reimbursement methodology school based health centers in order to increase the reimbursement rates for physical and occupational therapy.
