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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: Removes the application of the routine cost limit and customary charge limit for cost reimbursement of distinct part nursing facilities of critical access hospitals.
Summary: an extension of our approved exception to establishing a recovery audit contractor. In 2019, CMS approved KY SPA 19-006, which approved an exception through April 1, 2022.
Summary: Updates prescribing providers for preventive services from only physicians to license practitioners within the scope of their license which is in line with industry standards and federal language.
Summary: Authorizes the state to enter in Value-Based Purchasing (VBP) rebate agreements with drug manufacturers for drugs provided under the Medicaid program.
