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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: The Centers for Medicare & Medicaid Services (CMS) has reviewed the proposed Illinois state plan amendment (SPA) to Attachment 4.19-D IL-23-0027, which proposes increases to the reimbursement rate for facilities by the Department of Public Health under the ID/DD Community Care Act as an ID/IDD facility and medically complex for the developmentally disabled facilities licensed under the MC/DD Act.
Summary: The Centers for Medicare & Medicaid Services (CMS) has reviewed the proposed Illinois state plan amendment (SPA) to Attachment 4.19-D IL-23-0033, which proposes to increase by 12% the support component of the nursing facility rate for facilities licensed under the Nursing Home Care Act as skilled or intermediate care facilities.
Summary: The Centers for Medicare & Medicaid Services (CMS) has reviewed the proposed Wisconsin state plan amendment (SPA) to Attachment 4.19-A and B WI-24-0001, which was submitted to CMS on March 29, 2024. This plan amendment updates the Inpatient and Outpatient Hospital State Plans to increase the statewide Medicaid fee-for-service base rates for inpatient and outpatient services paid under the DRG and EAPG systems above and beyond the annual inflation increase.
Summary: This amendment modifies the maximum amount allowed for the maintenance of a home of institutionalized beneficiaries to reflect the Social Security Adjustment (COLA).
Summary: This SPA increases the Prospective Payment System rates for Federally Qualified Health Centers (FQHCs) and updates the definition of behavioral health encounters.
Summary: This Amendment in which the state disregards Tribal General Welfare Assistance (GWA) in determining financial eligibility for certain non-MAGI eligibility groups.
