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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: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to rescind the election of a separate increased reimbursement rate for Nursing Homes Facilities during the COVID-19 state of emergency.
Summary: revises the inpatient hospital services reimbursement pages of the State Plan to enhance clarity, modify the policy for updating the DRG statistical calculations, and add requirements for a biennial review of rural hospital rates.
Summary: This plan amendment increased the daily rate for Assisted Living Facilities on average by two (2) percent. The weighted average increase is expected to be $1.70, though this amount will vary based on the Comprehensive Assessment Reporting Evaluation classification of each individual client.
Summary: This amendment allows the state to pay up to the higher allowed payment for services provided for psychiatric long-term civil commitments when the claim is for an allowed service(s) and paid for by both Medicare and Medicaid.
Summary: This plan amendment removes an add-on code for component-based vaccine administration and counseling and reference the correct fee schedule date.
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 set reimbursement for COVID-19 testing & vaccine administration to FQHCs/RHCs/ERCs.
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 temporary rate increase for personal care assistance services and intermediate care facilities for people with developmental disabilities.
Summary: CMS is approving this SPA which amends the State Plan to increase the professional dispensing fee paid to pharmacies by 1% from $10.08 to $10.18.
