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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 State Plan Amendment increases the per diem reimbursement rate from $589.62 to $707.54 for nursing facilities that provide specialized care to ventilator-dependent residents.
Summary: This State Plan amendment proposes to increase the rate paid to any Medicaid-enrolled Large Private Intermediate Care Facilities for Individuals with Intellectual Disabilities that is licensed as a Comprehensive Rehabilitative Management Needs Facility.
Summary: Effective January 1, 2023 this amendment revises rate year (RY) 2023 reimbursement for privately-owned acute care hospital services. Specifically, it implements payment for: behavioral health crisis evaluation services; acute inpatient discharge add-on; and a Clinical Quality Incentive (CQI) program.
Summary: This plan amendment updates the methods and standards used to determine the rates of payment for surgery and anesthesia services.CMS is issuing this technical correction to state plan amendment (SPA) MA-23-0018. This technical correction includes an update to the superseding transmittal number in the footer of the plan page.
Summary: This SPA adds mandatory coverage of COVID-19 vaccine and administration, testing, and treatment benefits as required by Section 9811 of the American Rescue Plan Act.
Summary: This State Plan Amendment adjusts inpatient hospital rates to take into account increased labor costs resulting from statutorily
required increases in the New York State minimum wage. Specifically, the SPA updates the inpatient hospital minimum wage cost for the Remainder of the State region from $12.50 to $13.20 per hour. Total minimum wage cost is determined by applying total hours by the difference between the statutory minimum wage and the midpoint of each wage band plus the calculated fringe benefit.
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 provide Reimbursement of antibody infusions.
