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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 SPA updates language on the Delaware excluded drug coverage pages to reflect coverage of selective medications by referencing the state’s webpage and policy handbook resources instead of listing specific covered medications. Additionally, the SPA amends the Title XIX Medicaid State Plan regarding physician administered drug reimbursement rates.
Summary: The State provides for coverage of a maximum of twelve reserve bed days for the first six calendar months and 12 days for the second six calendar months of the year for recipient residents of Title XIX nursing facilities for the purpose of therapeutic home visits. The absence must be specifically provided for in the patient's plan of care and physician prescribed.
Summary: One-time supplemental payment in the amount of $1.2M to privately-owned CDR hospitals with Medicaid inpatient utilization exceeding 50%. Only one hospital qualifies for this payment.
Summary: The Supplemental Payment to Further Support Acute Hospital Financial Stability and Prevent Possible Impacts to Acute Hospital Service Provision and Access will provide further support to hospitals that are at risk of closure or reduction of services due to financial needs.
