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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: We have reviewed the proposed Colorado State Plan Amendment (SPA) to Attachment 4.19-B of your state plan, which was submitted to the Centers for Medicare & Medicaid Services (CMS) on July 01, 2021. This plan amendment provides a 2.5% rate increase for outpatient hospital services.
Summary: Provides for a 2.5% inflationary increase for per diem hospitals. Specifically, the 2.5% increase applies to the base rate per-diem calculated for specialty-acute care and rehabilitation hospitals.
Summary: allows durable medical equipment (DME) subject to the upper payment limit described in Section 1903(i)(27) of the Social Security Act to be reimbursed at or below 100% of the Medicare rates.
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 provide a one-time per member per month COVID-19 workload targeted case management payment in consideration for additional workload imposed on case managers.
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 add nursing rate for Personal Care Attendant Services and a flat nursing rate for the initial assessment to the U.S Virgin Islands Medicaid State Plan for both the categorically needy and the medically needy populations.
Summary: Effective for services on or after October 1, 2020, this amendment provides updates to the disproportionate share hospital (DSH) methodology, revises inpatient hospital supplemental payments, establishes the Hospital Transformation Program (HTP) and establishes the Rural Support Payment for outpatient hospital services.
