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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: Modifies Wisconsin's methodology for payment by adjusting the reimbursement rate for nursing homes and intermediate care facilities for individuals with intellectual disabilities.
Summary: This plan amendment implements the requirements of Section 1903(i)(27) of the Social Security Act concerning reimbursement for durable medical equipment.
Summary: This time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to increase the cap for supplemental disproportionate hospital share (DHS) payments to qualifying hospital providers.
Summary: Modifies inpatient and outpatient reimbursement rates,including for critical care supplements, wage area adjustment indices for border status hospitals, cost-to-charge ratios, and outpatient access payments effective January 1, 2020
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to provide for an extension of the reasonable opportunity period for non-citizens declaring to be in a satisfactory immigration status and to allow licensed practitioners practicing within their scope of practice such as nurse practitioners and physicians assistants, to order home health services.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow exceptions to the state's preferred drug list when shortages occur.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover the suspend all cost sharing for the Work Incentives group under 1902(a)(10)(A)(XIII) of the Social Security Act and extend all prior authorization by automatic renewal without clinical review or time/quantity extensions, and allow automatic renewal of prior authorization for medications without clinical review or time/quantity extensions.