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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 amendment for Tailored Care Management is to increase the Health Home payment rate for higher acuity beneficiaries and to provide assurances of mandatory Core Set measures.
Summary: This amendment allows the District to update the state’s excluded drug listing; to provide coverage for select agents for the treatment of infertility; to enter in Outcome-based arrangements with manufacturers; and to increase flexibility to improve access to prescription and over-the-counter drugs.
Summary: This amendment proposes to allow the remote delivery of Crisis Services for Individuals with Intellectual and/or Developmental Disabilities (CSIDD) through telephonic or other technology in accordance with State, Federal, and Health Insurance Portability and Accountability Act (HIPAA) requirements. Other technology means any two way, real-time communication technology that meets HIPAA requirements.
Summary: This amendment expands the number of acceptable ICD_10 Diagnoses for individual with the diagnosis of brain injury, behavioral health condition and/or substance abuse disorder.
Summary: This modifies the Graduate Medical Education (GME) Innovations Grant agreement to reflect a change in hospital partnership and an increase in the agreement amount funding available to providers in the state of Michigan providing accredited psychiatric residency training.
Summary: This amendment proposes to adjust the payment methodology for Long Term Care services. Specifically the amendment proposes to increase reimbursement rates resulting from a change to the 2009 cost report from the 2006 cost report as the basis for reimbursement rates.
