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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 transmitted a proposed amendment to your approved Title XIX State plan to implement section 4107 of the Affordable Care Act. This Affordable Care Act provision amended section 1905(a)(4) of the Social Security Act to add a new subsection (D) to provide Medicaid coverage of comprehensive tobacco cessation services for pregnant women. including both counseling and pharmacotherapy. without cost sharing.
Summary: This SPA transmitted a proposed amendment to your approved Title XIX State plan to address Section 6411 of the Affordable Care Act regarding the Medicaid Recovery Audit Contractors (RAC) program.
Summary: This amendment changes out-of-state hospital base rate amounts from a percentage of the in-state base rate to a specific dollar amount base rate for each hospital classification.
Summary: This SPA proposes amendments to Hawaii's approved Title XIX State Plan to eliminate certain optional services for Hawaii's QUEST beneficiaries, as well as to impose an inpatient service limitation on this population.
Summary: This SPA transmitted revisions to reimbursement language for transportation and therapies, and clarifications to coverage language for home health, private duty nursing, therapies, hospice, respiratory care, and certified pediatric/family nurse practitioner services.
Summary: This SPA transmitted a proposed amendment to Vermont's approved Title XIX State Plan to implement nonpayment provisions for healthcare acquired conditions/provider preventable conditions as required by 42 CFR 447.26.
Summary: This SPA transmitted a proposed amendment to your approved Title XIX State plan to elect the option provided by §214 of the Children's Health Insurance Program Reauthorization Act of 2009, Public Law 111-3. This option provides States, at their option: to grant full Medicaid coverage to all otherwise eligible alien children or pregnant women fully residing in the United States.
Summary: This SPA transmitted a proposed amendment to Vermont's approved Title XIX State Plan to revise the payment methodology for all hospitals for outpatient services to comply with Medicare OPPS 2011 payment provisions. A two-tiered rate structure will continue to pay the standard rates for each APC to out-of-state hospitals and an enhanced rate to in-state hospitals.
Summary: This SPA transmitted a proposed amendment to Vermont's approved Title XIX State Plan to implement Section 2301 of theAffordable Care Act with respect to payment for free-standing birth center services.
