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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: The purpose of this SPA is allow State operated and controlled Veteran's Affairs (VA) nursing facilities to include prescription drugs cost in their cost report as routine costs.
Summary: The state plan makes individuals receiving hospice services mandatory participants in BAYOU HEALTH and individuals receiving home and community based waiver services voluntary participants.
Summary: Adds unmarried pregnant women under the age of 21 as a reasonable classification of children under 42 CFR 435.222, and also disregards all household income for this group.
Summary: This amendment proposes to set methods and standards for establishing payment/per visit rates for Indian Health Services and an Outpatient Surgery rate will be set based on the average reimbursement rate paid to Ambulatory Surgery Centers in the previous year.
Summary: This SPA implements a new drug pricing methodology to reimburse pharmacies using National Average Drug Acquisition Cost files for pharmacies that dispense pharmaceutical products to Medicaid recipients.
