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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 amendment proposes adding coverage and payment methodology of Personal Care Attendant Services (PCAP) in the U.S. Virgin Islands Medicaid program, approved initially on March 25, 2021. At the time of approval, the end of the PHE was not known. Now that the date is known, this SPA has been updated to reflect an effective of May 12, 2023.
Summary: This amendment aligns the home health services rule with the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act, and federal regulation, by adding nurse practitioners, clinical nurse specialists, and physician assistants to the list of practitioners who can order home health services.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to add providers and specify provider qualifications (training and supervision requirements) as well as, to clarify 15 minute increment payment policy.
Summary: implements a maternity payment program to promote improved care experience for mothers by incentivizing participating obstetricians to promote high quality evidence based practices
Summary: Updates the payment pool amounts for the Rural Family Residency Development Payment, Family Medicine Residency Program Payment, State University Teaching Hospital Payment, and the Pediatric Major Teaching Payment
Summary: Updates the payment amount for the University of Colorado School of Medicine Supplemental Payment for Physician and Professional Services at qualifying Colorado State-Owned or Operated Professional Services Practices.
Summary: Effective for services on or after July 1, 2020, this amendment implements a 1 % across-the-board rate decrease for non-institutional services and psychiatric residential treatment facilities (PRTFs) as appropriated by the legislature during the 2020 legislative session.
Summary: Provides that pediatric specialty hospitals will receive a one percent reduction to each hospital’s July 1, 2019 Medicaid base rate. In addition, it updates the budget neutrality factor for state fiscal year (SFY) 2021.
