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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: Transmitted a proposed amendment to your Agency's approved Title XIX State plan to update the organizational structure of the single State agency. Specifically, you proposed to (1) rename the Medicaid unit the Department of Vermont Health Access; and (2) elevate mental health to a department within the single State agency.
Summary: This amendment clarifies language regarding the assessment of penalties for late filing of a cost report and the removal of the requirement that there must be a change in the total per diem cost of the applicable cost center by ten cents or more per patient day in order to submit an amended cost report and changes to the intermediate care facility for the mentally retarded (ICF-MR) chart of accounts and the inclusion of day programming costs in the direct care costs of an ICF-MR.
Summary: Exempts urgent care facilities and retail convenience clinics from the Primary Care Case Management requirement for written referral or authorization.
Summary: Prohibits the estate recovery of Medicare cost sharing benefits for dual eligible beneficiaries age 55 and over in compliance with Section 115 of the Medicare Improvements for Patients and Providers Act of 2008.
Summary: Establishing admission status codes known as 'present on admission' indicators, and by implementing thirteen percent increases for psychiatric per diem rates and bariatric case rates.
Summary: Updates the amounts of Arizona s graduate medical education and indirect medical education payment pools and designates the qualifying teaching hospitals for each payment pool for the fiscal period.
