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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: Continues an additional class of disproportionate payments for acute care hospitals with 400 or more setup and staffed beds in a county with a population less than 500,000.
Summary: Alignment with Section 1557 of the ACA as Implemented by Final Rule." SPA PA-16-0029 amends Attachment 3.1.A/3.1B, page iii, to align with Section 1557 of the Affordable Care Act as implemented in the final rule, "Nondiscrimination in Health Programs and Activities," issued by the United States Department of Health and Human Services, Office of Civil Rights on May 18, 2016. Specifically, the final rule at 45 CFR § 92.207, prohibits covered entities (which includes state Medicaid programs) from imposing categorical coverage exclusions for services related to gender transition. SPA 16-0029 removes language from the State Plan that would be in conflict with this federal rule.
