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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 plan amendment establishes a new class of supplemental payments to qualifying Medical Assistance (MA) enrolled acute care general hospitals that provide inpatient services to MA beneficiaries.
Summary: This amendment implements a performance standard for qualified entities and hospitals determining presumptive eligibility for the following Medicaid eligibility groups: Parent/Caretaker Relatives, Group VIII Adults, and Former Foster Care Children.
Summary: This plan amendment adds establishes a cost-based reimbursement methodology for NC Select Drugs, including Cell and Gene Therapies administered in the Hospital Inpatient, Hospital Outpatient, and Professional Outpatient settings.
