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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: Revise the provisions governing outpatient hospital services in order to establish the criteria for an acute care hospital to qualify as an urban metropolitan statistical area (MSA) facility and to establish the reimbursement methodology under that criteria.
Summary: increased federal financial participation (FFP) for newly-eligible individuals receiving postpartum coverage and further includes the addition of Attachment D, which describes the special circumstances and other proxy adjustments that are applied to account for the proportion of individuals covered under the extended postpartum coverage option who would otherwise be eligible for coverage in the adult group and for the newly eligible FFP under section 1905(y) of the Social Security Act;
Summary: The purpose of this SP A is to amend the provisions governing the federal medical assistance percentage (FMAP) to establish a proxy methodology to account for the proportion of medical assistance expenditures for beneficiaries receiving extended postpartum coverage.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to establish a direct wage floor and workforce retention bonus payments to long-term personal care providers, in accordance with the State's approved Home and Community Based Services spending plan authorized under Section 9817 of the American Rescue Plan Act.
Summary: amends the provisions governing intermediate care facilities for individuals with intellectual disabilities (ICFs-11D) in order to allow a one-time lump sum payment from the dedicated funding pool.
Summary: This SPA is to amend the provisions governing personal care services worker qualifications in order to remove minimum education and experience qualifications language.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to provide bonus payments to providers of personal care services and targeted case management to address the COVID-19 PHE and in accordance with the State’s approved Home and Community Based Services spending plan authorized under Section 9817 of the American Rescue Plan Act.
Summary: amends the provisions governing reimbursement to non-state intermediate care facilities for persons with intellectual disabilities in order to implement administrative penalties related to noncompliance with the direct care floor requirements.
Summary: Amends provisions governing reimbursement for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) in order to establish an alternative payment methodology which would allow reimbursement outside of the
current Prospective Payment System rate for community health worker services provided in FQHCs and RHCs.
