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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: This proposed plan transmitted an amendment to the approved Title XIX State plan making administrative changes to correct the renumbering of plan pages as well as to restore home health and private duty nursing reimbursement language which were inadvertently omitted under SPA 07-013.
Summary: This amendment specifies the qualifying criteria and payment methodology Delaware uses to determine payments to high cost outliers for inpatient hospital services.
Summary: The amendment updates the maximum allowable reimbursement for durable medical equipment services to more accurately match payments to the level of funding that was made available in the State Fiscal Year 2010 Appropriations Act.
Summary: This proposed plan transmitted an amendment to the approved Title XIX State plan proposing to reduce provider methadone maintenance rates to the Medicare Upper Payment Limit ($85.53 per week) or by 3%, which ever results in a higher rate.
Summary: This amendment revises the reimbursement methodology for Partial Care services provided by other health professionals authorized to administer mental health clinic services.
