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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 will update Third Party Liability (TPL) requirements as authorized under the Bipartisan Budget Act (BBA) of 2018 and the Medicaid Services Investment and Accountability Act (MSIAA) of 2019.
Summary: This amendment revises the supplemental payment methodology to Nursing Facilities (NFs) for state fiscal year (SFY) 2022. Specifically, Idaho Medicaid will utilize a one-year NF Patient-Driven Payment Model (PDPM) Upper Payment Limit (UPL) methodology to distribute supplemental payments to qualifying providers.
Summary: This amendment is to increase an income disregard for an optional eligibility group serving individuals who are 65 years old or older or who have blindness or a disability.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to modify payments to providers in line with the state’s American Rescue Plan Home and Community Based Services (HCBS) Spending Plan.
Summary: modify the Case Management reimbursement and structure for the Primary Care Case Management Program known as Healthy Connections, and align it with the Healthy Connections Value Care Program.
