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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: Defines the Basic Alternative Benefit Plan (Basic ABP) Targeted to Serve Low-Income Children and working Age Adults with Eligible Dependent Children.
Summary: Removes the Idaho Enhanced Benchmark Benefit Package (EBBP) to comply with the requirements in the Affordable Care act to ensure that the essential health benefits and other standards are met.
Summary: This SPA defines the Enhanced Alternative Benefit Plan (Enhanced ABP) targeted to serve individuals with special health care needs operating under section 1937 authority of the Social Security Act (the Act).
Summary: Updates the targeted case management state plan to include eligible services provided to children with a serious emotional disturbance (as defined in Federal, Register; volume 58, no. 96, published May 20; 1993, pgs. 29422 through 2942) who are between the ages of four (4) and twenty one (21) and who are being served by the Care Management Entity (CME) or by the Children' s Mental Health Waiver.
Summary: Amends Idaho's current 1915(i) state plan benefit for children with developmental disabilities by adding "Early Intervention Provider" as a provider type. In addition, this SPA revises the quality improvement strategy language in order to align it with current state plan home and community-based services strategies.
Summary: Revises the calculation of the inpatient private hospital upper payment limit through the application of Medicare's prospective payment system, which is diagnosis-related group approach.
Summary: Wyoming is seeking to update the targeted case management state plan for Medicaid eligible individuals (consumers) who are residing or waiting to be placed, in a Medicaid certified acute care facility or nursing facility and express an interest in returning to the community rather than reside in a facility and qualify based on the targeted case manager's assessment as a good candidate for community living.
Summary: Transfers the fee schedule for therapies physical, occupational and speechf rom the body of the State plan to the State's website, and eliminates a general procedure code for speech therapy evaluation- replacing this code with four more descriptive procedure codes.
