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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 eliminates certain hospital rate enhancements (AREs) from the state plan and updates Diagnosis Related Group (DRG) reimbursement rates for hospital inpatient services in order to adjust rates for providers that previously received AREs and participated or did not participate in year one of the state's Directed Payment Program (DPP). The amendment also increases payments for the purpose of raising wages for employees of Medicaid providers to at least $15.00 per hour, includes a Children’s Hospital per-discharge add-on payment, modifies the payment methodology for GME to update the list of specialties in statewide supply-and-demand deficit, adds funding for mental health and psychiatry resident positions, provides an increase in the organ transplant provider rate, and makes technical and editorial changes.
Summary: This state plan amendment updates Long-Term Care Reimbursement provisions related to provider submission requirements when submitting annual Fair Rental Value (FRV) surveys, specifies that the state may amend FRV survey data based on audit results, removes a transitional rate provision in place since 2016 that reimbursed at the greater of a provider's prospective payment rate or its previous cost-based rate, increases funding to providers to establish a legislatively mandated $15.00 minimum wage, and updates State Plan UPL methodology to specify the use of the most recent cost reports for 2022-2023 UPL calculation.
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 amend the methodology for retention payments to providers delivering HCBS attendant and nursing services through the provider agency and consumer directed services option in the following state plan services: Community Attendant Services program; Primary Home Care program; day activity and health services; Community first choice (CFC) personal assistance services and CFC habilitation services; 1915(i) Home and Community-Based Services--Adult Mental Health Program; and personal care services.
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 increase rates for certain Home and Community-Based Services. This SPA increase rates for personal care services and behavioral health services by 70 percent for a temporary period ending March 31, 2023.
Summary: Effective for services on or after July 1, 2022, this amendment implements supplemental payments to nursing facilities based on discharges and staff wages.
