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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 establishes an emergency interim payment methodology for inpatient and outpatient hospitals affected by the Change Healthcare cybersecurity incident.
Summary: This Amendment align with Section 5112 of the Consolidated Appropriations Act (CAA, 2023), which requires that state provide 12 months of continuous eligibility (CE) for children under the age of 19 in Medicaid and the Children's Health Insurance Program (CHIP).
Summary: This amendment will replace instances of the term "Naloxone" with the broader term "opioid overdose reversal agent" as newer products of the class become available.
Summary: This state plan amendment amends 7.7-A of the Vaccine and Vaccine Administration at Section 1905(a)(4)(E) of the Social Security Act template to remove CPT 99401 with modifier CR from the SPA language.
Summary: The state raises the income eligibility standard for its Family Planning eligibility group from 133 percent of the federal poverty level (FPL) to 205 percent.
Summary: Amendment to increase acute rates for freestanding psychiatric hospitals paid on a per diem and to restore the 15% rate reduction for Acute II facilities while also increasing the restored rate by 5%.
Summary: The purposed amendment will increase the base rate for standard nursing facilities, nursing facilities serving patients with Acquired Immune Deficiency Syndrome (AIDS), and standard private and specialized private intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs).
Summary: Amendment to add provisions to comply with the requirements of 42 CFR Part 447, Subpart A, and sections 1902(a)(4),1902(a)(6), and 1903 with respect to non-payment for provider-preventable conditions.
