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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: This amendment proposes to allow Medicaid-enrolled pharmacists to bill Maryland Medicaid for professional services rendered within their lawful scope of practice.
Summary: Establish professional rates for services provided to beneficiaries who are identified by the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals as developmentally disabled and will be reimbursed at distinct rates. Rates will differ based on whether the service is delivered in a community setting or in an office or via telehealth.
Summary: This State Plan Amendment proposes to update the Historical Data Period referenced for current and upcoming Performance Years in the physician services Alternative Payment Model 2, and removes obsolete dates referenced in the payment methodology.
Summary: The purpose of this SPA is to amend the provisions governing disproportionate share hospital (DSH) payments to establish the qualification criteria and methodology for payments for the uncompensated care costs of inpatient psychiatric hospitals located in the northern area of the state with an academic training mission for services provided to uninsured and low-income individuals from the payment pool created in accordance with Act 447.
Summary: This state plan amendment incorporates additional funding for the Quality Incentive Budget as outlined in the state’s annual appropriations act and makes additions to the existing system of Quality Incentive Add-on Calculations.
