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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: 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 implement home health increases consistent with the state's ARPA sec. 9817 HCBS spending plan: 1. effective July 1-31, 2021, 3.5% rate increase for services other than pediatric complex skilled nursing and additional 1% value-based payment and 2. one-time supplemental payment calculated at 5% of SFY 2021 expenditures.
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 delay rebasing of FQHC rates to January 1, 2022 and every three (3) years thereafter.
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 modify payments to providers in line with the state’s American Rescue Plan Home and Community Based Services (HCBS) Spending Plan.
Summary: Decreases inpatient hospital base rates by one percent, updates the Diagnostic Related Group (DRG) methodology to adopt Version 38 of the All Payor Refined (APR) DRG grouper system and incorporates modifications to payment adjustors.
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 increase reimbursement for vaccine administration to $100 per dose in cases where vaccine administration is separately reimbursable at a fee amount.
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 implement one-time supplemental payments to nursing facility (NF), intermediate care facility (ICF), and hospice Medicaid providers for COVID-19 relief.
Summary: The purpose of this SPA is to align with KRS 205.56-1 to 205.5603 to reflect the methodology for increasing Medicaid reimbursement for ground ambulance services.
Summary: Add hospice attending physician service reimbursement rates to FQHC and RHC PPS rates. Section 132 of the Consolidated Appropriations Act, 2021 amended section 1834(0) of the Act and added a new section 1834(y) to the Act, to provide the authority for both FQHCs and RHCs, respectively, to receive payment for hospice attending physician services.
Summary: Implements a 1% Cost of Living Adjustment to the reimbursement fees for the NYS office of Mental Health Licensed Outpatient and Rehabilitative programs.
