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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: To revise the reimbursement methodology for comprehensive Health Home services provided to adults and children with significient mental health and co-occurring diagnoses.
Summary: Proposes for the aged, blind, and disabled medically needy group to disregard the amount by which an individual's Meedicare part B premium is reduced through enrollment in a Medicare Advantage Program.
Summary: This SPA specifies the dental benefits provided by Puerto Pico Medicaid Program to children under 21 years and beneficiaries over 21 years old.
Summary: Updates payment methodology to reduce reimbursement for state specified, non-emergency use of the emergency department for in-state acute care non-critical access hospitals.
