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: Updates the pricing methodology for hospital services utilizing certain specialty drugs delivered in the inpatient hospital setting, paying a percentage of net invoice cost or full invoice cost, depending on the drug.
Summary: This plan amendment is adding Inter-professional Consultation and Collaborative Care Services under the District’s physician services benefit.
Summary: This amendment updates methods and standards for establishing Medicaid Disproportionate Share Hospital (DSH) payments to qualifying DSH hospitals using the base year cost reporting period ending Fiscal Year 2022 to calculate interim DSH payments for the October 1, 2023, through September 30,2024, DSH payment period, and updating the inflation rate used to trend DSH base year cost to the end of the 2022 calendar year. The SPA also updates inpatient hospital swing bed and administrative day rates based upon the October 1, 2023, redetermination of nursing facility payment rates.
Summary: This amendment updates inpatient acute hospital payment methods and standards. The amendment also authorizes supplemental payment to qualifying acute hospitals and establish payment rates for new behavioral health and substance abuse use disorder services rendered in the hospital. Additionally, this amendment sunsets the state's pay-for -performance program but continue new incentive payment previously approved under the stat's clinical quality incentive program and its hospital quality and equity incentive program.
