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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: The purpose of this SPA is to amend the provisions governing disproportionate share hospital (DSH) payments to establish the qualification criteria and methodology for payments for the uncompensated care costs of inpatient psychiatric hospitals located in the northern area of the state with an academic training mission for services provided to uninsured and low-income individuals from the payment pool created in accordance with Act 447.
Summary: This state plan amendment incorporates additional funding for the Quality Incentive Budget as outlined in the state’s annual appropriations act and makes additions to the existing system of Quality Incentive Add-on Calculations.
Summary: The purposed amendment will add the current process of implementing updated inpatient and outpatient hospital per diem rates published by the by Indian Health Services (IHS) in the Federal Register.
Summary: We have reviewed the proposed amendment to Attachments 4.19-D of your Medicaid State plan submitted under transmittal number 24-0001 titled “Payment for Services: Nursing Facility Services - Ventilator Program.”
Summary: This amendment continues authorization for Medical Assistance Day One Incentive (MDOI) payments to nonpublic nursing facilities and provides the funding levels for the MDOI payments for Fiscal Year (FY) 2023-2024.
Summary: The definition of rural designation for inpatient psychiatric services is changed from an average county population density of 225 per square mile to 300 per square mile based on 2020 census data.
