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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 SPA proposes to amend the State Plan to create a new, temporary non-preferred status, and establish criteria for new-to-market drugs that have not yet been reviewed by the Drug Utilization Review Board.
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.
Summary: Proposes to remove the final settlement process language for non-state-government-owned and state-government-operated hospitals that limits the reimbursement to no more than cost for outpatient hospital services.
Summary: This amendment revises the State's reimbursement methodology for setting payment rates for hospital services. Specifically, it will amend the plan language to revise inconsistent and ambiguous language and correct examples of the rate setting methodologies.
