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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 SPA proposes to implement an evidence-based payment methodology for the reimbursement of nursing services provided in nursing facilities, using the 48-Group, Resource Utilizations Group IV classification scheme and weights published by The Centers for Medicare & Medicaid Services.
Summary: Revise the community spouse allowance, the community spouse income standard, the home equity limit, resource exemptions as well as the begin date of the penalty period.
Summary: Implements a Savings and Quality Based Pay-for-Performance incenive payments among the following Coordinating Entities; Care Coordination Entities for Persons with Disabilities, Care Coordination Entities for Children with Special Needs, Accountable Care Entities, and Medical Home Network.
Summary: Alternative Benefit Plan Realigns the ABP services to those available under the state plan. Revises limitations to pediatric, dental, physical therapy occupational therapy, and speech therapy services.
Summary: This SPA increases the monthly income standards for Domiciliary Care to reflect the 1.7% SSI Cost of Living Adjustment increase from the Social Security Administration.
