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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: 2.0% rate increase for outpatient hospital services per state budget bill, effective July 1, 2022. The amendment also modifies payments for new and out-of-state hospitals by creating more accurate groupings for calculating out-of-state and new hospital rates, effective September 1, 2022
Summary: implements a 2.0% across-the-board rate increase for included services within SPA CO-22-0018 and targeted rate increases and rate decreases, per state statute
Summary: The group will cover individuals with household income up to 260 percent of the federal poverty level (FPL), the state’s current income standard for pregnant individuals in its Children’s Health Insurance Program.
Summary: Updates the reimbursement methodology for the state’s Hospital Back-Up Program. Specifically, rate setting will be based on the level of care needs of members, prospectively.
Summary: upgrades the version of Enhanced Ambulatory Patient Group (EAPGs) in use for calculation of fee for service outpatient hospital payment in order to align payment with modern outpatient healthcare delivery standards.
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 revise the percentage of net invoice cost paid for Outpatient Hospital Physician Administered Drugs.
