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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 is amending its state plan to transition from the RUG III methodology to the Patient Driven Payment Model (PDPM) to calculate each individual price-based long term care facility’s average case-mix.
Summary: The purpose of this SPA is to adjust inpatient psychiatric fee-for-service per diem rates of reimbursement for distinct exempt units specializing in inpatient psychiatric services in Article 28 hospitals by increasing the case mix neutral psychiatric statewide per diem base price from $742.86 to $950.43.
Summary: This amendment is for Health Home Services to comply with a federal State Health Official letter directing states to submit a State Plan Amendment attesting to compliance with the CMS mandatory annual state reporting for specified Core Set Measures for measuring and improving the quality of care delivered to Medicaid and CHIP beneficiaries.
Summary: This plan amendment authorizes the Department to make an additional payment to nonpublic and county nursing facilities that qualified for supplemental ventilator care and tracheostomy care payments.
Summary: This plan amendment authorizes the Department to make an supplemental payment to certain nonpublic nursing facilities in a county of the eighth class.
Summary: The proposed amendment updates the Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program fee schedule, effective October 1, 2024.
