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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 plan amendment funds an additional class of supplemental payments to qualifying hospitals and to discontinue certain disproportionate share hospital payments and supplemental payments in Fiscal Year 2024-2025.
Summary: This plan amendment will continue the funding of inpatient disproportionate share hospital (DSH), outpatient supplemental, direct medical education payments, and certain DSH and supplemental payments for new hospitals. There will be no changes to the qualifying criteria or payment methodologies.
Summary: This plan amendment adds a 1% increase to operating components of inpatient rates of reimbursement for hospitals certified under Article 28 of the Public Health Law, as well as out-of-state acute care hospitals, for dates of services on or after April 1, 2022.
Summary: This plan amendment provides to continue the previously authorized wage increase for in person care for Medicaid beneficiaries provided by all clinical direct care workers and eligible non-clinical direct care workers in Medicaid-certified skilled nursing facilities.
Summary: Effective November 20, 2024, this SPA amends the provisions governing the Pharmacy Benefits Management Program in order to align the language relative to vaccine administration and fees with CMS requirements.
Summary: This plan amendment updates the nursing facility reimbursement rate budget adjustment factor and the Class Line 504 amount, effective July 1, 2024. This amendment also updates the plan language to refer to Patient Driven Payment Model (PDPM) for purpose of the case mix calculation.
