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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: Provides full Medicaid coverage qualified alien children and pregnant women who are are fully residing in the U S but have either not met the 5 year waiting period or 5 year bar under Section 403 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 or are nonqualified aliens lawfully residing in the U S who are other otherwise eligible for such assistance.
Summary: Proposed to change the term "domiciliary facility" to "adult care home" and to identify specifics of personal care services coverage within the adult care home. The SPA was reviewed for the description of Personal Care Services in Adult Care Homes and whether the service violated comparability, freedom of choice of provider, and provider qualification requirements.
Summary: This amendment implements Section 112 of MIPPA, which increases the resource standards for QMBs, SLMBs and Qls to conform to the resources limits for individuals who qualify for Medicare Part D Low-Income Subsidy (LIS).
Summary: Apply an overall negative inflationary adjustment of 5.02 percent for SFY 2010 and freeze rates for SFY 2011 for Personal Care Services (Adult Care Homes).
Summary: Aligns the resource limit for Qualified Medicare Beneficiaries Specified Low Income Medicare Beneficiaries and Qualifying Individuals with the resource limit for individuals who qualify for the full subsidy under the Medicare Part D Low Income Subsidy program.
Summary: This SPA modifies the methods and standards for setting payment rates for inpatient hospital services furnished by hospitals in the District of Columbia. It also modifies the rate setting assumptions for childrens residential treatment centers. Specifically, this SPA provides that effective October 1, 2009 the disproportionate share factor used in setting rates for inpatient hospital services in the District of Columbia will be reduced by two percent and creates a separate method for making payments to childrens residential treatment centers beginning December 1, 2009.
