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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 SPA updates the payment methodology for licensed pharmacist services to align with physician payment for the testing, prevention, or treatment of human immunodeficiency virus (HIV) or hepatitis C.
Summary: This plan amendment updates the Disproportionate Share Hospital (DSH) program reimbursement methodology and revises the DSH allotment distributed among eligible hospitals.
Summary: This plan amendment updates the plan by removing Medicare and other third party (non-Medicaid) ancillary costs from the allowable Medicaid reimbursement for Class I nursing facilities.
Summary: This plan amendment updates the plan by revising the Pay-For-Performance Supplemental Medicaid payment methodology to Class 1 nursing facilities from a per-diem add-on dollar amount to a flat per-diem multiplier methodology.
Summary: This plan amendment edits the provisions governing reimbursement for hospice services in order to ensure that the current payment methodology aligns with CMS requirements.
Summary: This plan amendment will permit the District of Columbia Medicaid program to reimburse public specialty inpatient hospitals at a rate that is fair and reasonable.
Summary: This plan amendment extends the Non-Designated Public Hospital Supplemental Fund program for the state fiscal year ending 2025, effective July 1, 2024.