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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: Continuing disproportionate share hospital payments to facilities that further Pennsylvania's goal of enhanced access for Medicaid beneficiaries.
Summary: Continuous eligibility allowing children under the age of 4 to maintain Medicaid coverage for a full year, even if families experience a change in income or household size.
Summary: Continuing disproportionate share hospital payments to facilities which are members of the Alliance of Independent Academic Medical Centers and ranked at least three standard deviations above the mean Medicaid inpatient days.
Summary: Continues DSH payment adjustments to qualifying hospitals that serve indigent populations of cities with an average per capita income signiflrcantly below statewide averages.
Summary: Continuing disproportionate share hospital payments to facilities that have a low commercial payment ratio and a negative trend in net patient revenue.
