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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: Adds the optional Medicaid eligibility group which provides coverage to women and men that is limited to family planning and family planning-related services under the state plan.
Summary: This SPA changes the retroactive effective date of eligibility for all eligibility groups except Qualified Medicare Beneficiaries from the date of eligibility/application to the first day of the month of eligibility/application under the Medicaid State plan.
Summary: This SPA extends Medicaid coverage for an initial period of 12 months for low-income families who no longer qualify for Medicaid due to increased earned income or working hours from the caretaker relative's employment, or due to the loss of a time-limited earned income disregard.
Summary: Updates Physicians and Other Practitioners' Fee Schedule and Changes the Reimbursement Methodology for Physician Administered Drugs and Biological Products When a New National Procedure Code is Assigned.
Summary: Allows Hospitals Separate Reimbursement for Long Acting Reversible Contraceptive (LARC) Devices Provided in the Inpatient Hospital Setting Immediate Postpartum.
