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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: Updates reimbursement rates for medical supplies and durable medical equipment as part of the 21st Century Cures Act. Additionally, it adds coverage of specialty modified low protein foods and their reimbursement methodology.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to provide a per diem increase to nursing facility and HIV nursing facility per diem reimbursement rates of ten dollars and eighteen cents ($10.18) effective for dates of service July 1, 2021 through June 30, 2022.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to allow for the administration of the COVID-19 vaccine to be reimbursed at a set fee equal to the same amount approved for the vaccine administration in a physician’s office and outside of the daily case mix rate of Nursing Facilities.
Summary: Allows Physician Assistants to bill independently for service, and further includes physician assistants within the payment rate of the other providers affiliated within the University of Utah Medical Group
Summary: This plan amendment allows the Division of Medicaid (DOM) to 1) set the fees for orthotics and prosthetics the same as those effective State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement reduction.
Summary: This plan amendment allows the Division of Medicaid (DOM) to 1) set the fees for nurse practitioner and physician assistant services the same as those in effect State Fiscal Year (SFY) 2021, and 2) remove the five percent (5%) reimbursement reduction.
