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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: We have reviewed the proposed Colorado State Plan Amendment (SPA) to Attachment 4.19-B of your state plan, which was submitted to the Centers for Medicare & Medicaid Services (CMS) on July 01, 2021. This plan amendment provides a 2.5% rate increase for outpatient hospital services.
Summary: Proposes to move currently approved in-home peritoneal dialyses services from the clinic benefit to the home health and other licensed provider benefit without a change in reimbursement
Summary: This amendment updates the methodology for establishing PRTF payment rates, establishes a supplemental payment for Lake Taylor, revises GME residency payments and the IME formula freestanding children's hospitals, and makes multiple revisions for nursing facility reimbursement.
Summary: This plan amendment implements community mental health center and substance use disorder agency inflationary rate increases appropriated by the state legislature during the 2021 legislative session
Summary: The purpose of this SPA is to update the Program of All-Inclusive Care for the Elderly (PACE) rate methodology in the South Carolina State Plan.
Summary: Adds coverage and payment provisions to the Ohio Medicaid state plan for lactation counseling services provided by dieticians. Coverage and payment for lactation counseling provided by dieticians is being added to assist with improving the health of the population and reducing future preventable causes of poor health, such as obesity, in infants. CMS supports this action because it will improve infant health overall
Summary: This SPA proposes to allow the Division of Medicaid (DOM) to 1) revise coverage and payment methodology for extended services for pregnant and post-partum women who are at risk of morbidity or mortality, 2) set the fees for extended services for pregnant women the same as those in effect on July 1, 2021, and 3) remove the five percent (5%) reimbursement reduction effective July 1, 2021.
