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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 amendment clarified revisions to the inflation projection methodology for the Day Activity and Health Se1vices (DAHS), 1915 Home and Collllllunity-Based Se1vices-Adult Mental Health (HCBS-AMH), Inte1mediate Care Facilities for Individuals with an Intellectual Disability (ICF/IID), Nursing Facility (NF), and Primaiy
Home Cai·e (PHC) programs. A revision will also be made to the nursing wage inflation methodology, which will affect only the DAHS, HCBS-AMH, ICF/IID, and NF programs.
Summary: This amendment provides for reimbursement under single case agreements for inpatient hospital services, outpatient services and nursing facility services where there is a lack of existing New Hampshire enrolled providers able to provide the medically necessary specialized services.
Summary: The purpose of this amendment is to temporarily increase payment rates for fee for service state plan home and community based services through quarterly supplemental payments based upon a percentage of Medicaid allowable paid claims in order to maintain a stable workforce and preserve services during the declared public health emergency.
Summary: This SPA is adding mandatory benefits regarding coverage of COVID-19 vaccines, testing, and treatments to the Medicaid State Plan. The state submitted the completed ARP preprints for COVID Vaccines, Testing, and Treatment.
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 the per-day rate for the Therapeutic Communities service.
Summary: This State Plan Amendment adds the Collaborative Care Model as a reimbursable service under the Medical Assistance (MA) program under physician services.
Summary: Updates the inpatient hospital reimbursement methodology for Indirect Graduate Medical Education (IME) payments to specify calculation of annual IME payments based on the most recently filed and available cost reports. The amendment also adds inpatient state directed payment arrangements allowed under 42 CFR 438.6(c) approved pre-prints and made through managed care plans (“Inpatient DRG Enhanced Rate”) to the calculation of annual IME payments.
Summary: Makes a change to the State Plan to revise Medicaid reimbursement for inpatient or outpatient hospital services provided by a children's hospital located in a state bordering Indiana.
Summary: The amendment seeks to update Rhode Island’s Medicaid State Plan to provide assurance of coverage of COVID-19 vaccine administration, testing, treatment, and stand-alone vaccine counseling for children.