An official website of the United States government
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
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 updates the nursing facility reimbursement rate budget adjustment factor and the Class Line 504 amount, effective July 1, 2024. This amendment also updates the plan language to refer to Patient Driven Payment Model (PDPM) for purpose of the case mix calculation.
Summary: This plan amendment revises the reimbursement methodologies for Psychiatric Residential Treatment Facilities (PRTF) and hospital supplement payments for freestanding children's hospitals with greater than fifty percent Medicaid utilization.
Summary: This plan amendment updates the plan by making adjustments to the All Patient Refined-Diagnosis Related Group (APR-DRG) to align with Version 40.
Summary: This plan amendment removes obsolete language increasing the nursing facility per diem rate by $6.13 per day. That increase has now been absorbed into the standard per diem methodology and rates.
Summary: The proposed amendment updates the fee schedule for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) and Vision Care Services. Fiscal impact is for reimbursements for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) and Vision Care Services effective date of September 1, 2024.
