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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: Allows the exclusion of federal and state tax refunds and refundable tax credits as income when determining eligibility for Medicaid for certain mandatory and optional categorically needy groups under the SSA Act.
Summary: Allows the exclusion of federal and state tax refunds and refundable tax credits as income and resources when determining eligibility for Medicaid for low-income families covered under Section 1931 of the Social Security Act
Summary: This amendment modifies section 15 of the State plan that provides for additional disproportionate share hospital (DSH) payments to hospitals serving low-income persons.
Summary: This amendment modifies section 15 of the State plan that provides for additional disproportionate share hospital (DSH) payments to hospitals serving low-income persons.
Summary: Updates the payment methodology for Hospice Care and implements a blank supplemental page to address future hospice rates that may be adjusted.
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 amendment represents a complete rewrite of Attachment 4.19-D for nursing facilities (NFs), caps the NF per diem indirect care incentive payment at $9 .50, and reduces the NF inflation index adjustment from two-percent to one-percent.
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.
