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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: The purpose of this State Plan Amendment is to provide assurances that the State is in compliance with the screening and enrollment of providers pursuant to 42 CFR 445.
Summary: This amendment modifies the State's methods for setting peer group medians and pricing for the special rehabilitation nursing facilities (SRF).
Summary: This amendment proposes implementation of lead case management and enviromental lead investigation services for individuals who tested for elevated blood lead levels.
Summary: This amendment adds language that allows Pennsylvania to recover overpayments of disproportionate share (DSH) payments that exceed a hospital's specific DSH limit as defined by section 1923(g) of the Social Security Act.
Summary: This SPA clarifies the service descriptions and provider qualifications for behavioral health services provided under the rehabilitation services component of the State Plan.
Summary: Extends the sunset date of February 29, 2012 to January 1, 2013 in the North Carolina State Plan for Personal Care Services (PCS) provided to individuals living in a private residence, as well as PCS furnished in an Adult Care Home (ACH), Family Care Home, or a Supervised Living Home.
Summary: Proposes to transition remedial services to managed care (MC) and reimburse non-MC providers on a fee schedule. The program name is also changing to Behavioral Health Intervention Services.
Summary: This amendment seeks to eliminate Targeted Case Management services for Individuals with HIV, Pregnant Woman, Persons Identified as Seriously Mentally Ill or Seriously Emotionally Disturbed, Low Functioning Severely and Persistently Mentally Ill Adults Needing Assertive Community Treatment (ACT), Individuals with Developmental Disabilities, and Case Management for. Elderly or Disabled Individuals Diverted/Deinstitutionalized from Nursing Facilities from the State Plan.
