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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: Provides for a Per Diem Rate Reimbursement for Long-Term Care Facilities Serving Persons Less than 22 Years of Age with Clinically Complex Residents.
Summary: Makes Comprehensive Revisions to Large Sections of the Inpatient and Outpatient Service Definition and Reimbursement Sections of the State Plan.
Summary: SNF/Ped Facilities that Serve Exceptional Care Patients and Have 30% or More of Their Patients Receiving Ventilator Care Shall Receive An Additional Payment of $165.52 Per Day for Ventilator Care.
Summary: Reduces the dispensing fee from $2.40 to $1.40 for single source drugs, $4.50 to $3.50 for multiple source drugs and $12.00 to $11.00 for 340B purchased eingle source and multiple source drugs.
Summary: To update the pharmacy coverage section of the state plan to align with requirements of Section 175 of the Medicare Improvement for Patients and Providers Act of 2008.
Summary: The purpose of this SPA is to amend the State's approved Title XIX State Plan to update the state's Preadmission Screening and Annual Resident Review (PASRR) methodology to align it with the state's PASRR manual. This SPA is cost neutral.
Summary: Updates the Non-Emergency Medical Transportation Services section of the state plan to be consistent with the State's approved 1915 (b) waiver for NEMT services.
