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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 will allow treatment in place and mobile integrated health services to be provided by emergency services transporters under the supervision of a physician. Treatment in place will reimburse at a rate of $150 and mobile integrated health services will reimburse at a rate of $150 per event.
Summary: This State Plan Amendment increases the inpatient hospital per-diem rate of reimbursement for extended observation bed (EOB) services in hospital-based comprehensive psychiatric emergency programs (CPEP), subsequent to a CPEP full or triage and referral visit and where the beneficiary remains in the CPEP for longer than 24 hours.
Summary: This State Plan change will allow Medicaid to reimburse for Opioid Treatment Program (OTP) services provided to individuals with an Opioid Use Disorder. OTP services are being revised to allow for a bundled payment consistent with Medicare rates that utilizes an integrated service model that includes medication, medication administration, counseling, laboratory tests and case management services.
Summary: This State Plan Amendment updates Nursing Home reimbursement rates to the 2020 nursing home cost reports. The SPA also updates calculation of the Property and Related Net Per Diem established under the FRV System by increasing the rate for construction cost for nursing facilities from $187.12 to 198.86, as derived from the 2020 RSMeans Building Construction cost data for Nursing Homes.
Summary: This amendment, effective October 1, 2022, authorizes the Arizona disproportionate share hospital (DSH) pool 1, 2, 1A, 2A and 4 payments, for the DSH state plan rate year ending 2023.
Summary: Effective July 1, 2022, this amendment renews and updates the state's critical access hospital inpatient supplemental payments for the state fiscal year ending June 30, 2023.
Summary: The purpose of this SPA is to add mandatory coverage of COVID-19 vaccine and administration, testing, and treatment benefits as required by Section 9811 of the American Rescue Plan Act.
Summary: The purpose of this SPA is to add mandatory coverage of COVID-19 vaccine and administration, testing, and treatment benefits as required by Section 9811 of the American Rescue Plan Act.
