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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: California Disaster Relief (DR) SPA 22-0038 will temporarily implement the addition of Self-Directed Support Services and Technology Services and temporarily implement increases to incentive payments for Prevocational and Supported Employment Services. This SPA is effective July 1, 2021 through the end of the COVID-19 Public Health Emergency (PHE).
Summary: 2.0% rate increase for outpatient hospital services per state budget bill, effective July 1, 2022. The amendment also modifies payments for new and out-of-state hospitals by creating more accurate groupings for calculating out-of-state and new hospital rates, effective September 1, 2022
Summary: Revises the provisions governing inpatient hospital services in order to establish the criteria for an acute care hospital to qualify as an urban metropolitan statistical area (MSA) facility and to establish the reimbursement methodology under that criteria.
Summary: Increases rates to services provided by Psychiatric Rehabilitation Services provided by Community Mental Health Centers and Independent Clinics (except for Federally Qualified Health Centers (FQHCs)), Ambulatory Surgical Centers, Medicaid Children’s Clinics, Public Health Clinics, and Planned Parenthood Clinics. Based upon the information provided by the State
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to implement a 10% rate increase for providers of Title XIX Home and Community Based Services as follows: (HCB) Personal Care Services, 1915(k) Community First Choice Services (CFC), and Long-Term Services and Supports Targeted Case Management Services(LTSS-TCM). The department intends this increase to facilitate increased wages and promote the hiring and retention of HCBS direct service workers, an area adversely impacted by the COVID-19 pandemic.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to extend the 5% increase in payment rates for ODDS services and settings for the period 7/1/22 through 9/30/22 or until the end of the PHE, whichever is first.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to establish a direct wage floor and workforce retention bonus payments to long-term personal care providers, in accordance with the State's approved Home and Community Based Services spending plan authorized under Section 9817 of the American Rescue Plan Act.
