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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: Increases the overall outpatient rates for services provided in federally designated critical access hospitals (CAHs) by 5% and state designated CAHs by 3%.
Summary: Requires States that recognize freestanding birth centers to providecoverage and separate payments for freestanding birth center facility services and servicesrendered by certain professionals proyiding services in freestanding birth centers.
Summary: This SPA authorizes the election by a parent of the hospice benefit which will not constitute a waiver of any rights relating to treatment of a child's condition when it has been determined the condition is terminal.
Summary: This SPA discontinue coverage of legend (prescription only) brand and generic agents used for symptomatic relief of cough and cold. The Agency will continue to cover certain over-the-counter (OTC) cough and cold products in an effort to provide cost effective alternatives to recipients.
Summary: The plan amendment clarifies the orthotic and prosthetic services available under Early and Periodic Screening, Diagnosis and Treatment (EPSDT) recipients under the age of 21. The amendment change does not have a direct impact on Indians, Indian Health programs, or Urban Indian Organizations.
Summary: Which provides for smoking cessation program services covered for all participants who smoke when prescribed by a physician or health care professional with prescribing authority including smoking cessation products with behavioral intervention services provided by a wide range of healthcare provider specialties.
