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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 allows the State to establish programs to contract with one or more Medicaid Recovery Audit Contractors (RAC), in accordance with Section 6411 of the Affordable Care Act. The purpose of the Medicaid RAC is to identify overpayments and underpayments to recoup overpayments under the State Plan and under any waiver of the State Plan.
Summary: This SPA transmitted a proposed revision to Connecticut's approved Title XIX State Plan in order to describe its process for consultation with Connecticut's federally-recognized Indian Tribes.
Summary: This SPA transmitted a proposed revision to Connecticut's approved Title XIX State Plan in order to establish a program to contract with a Recovery Audit Contractor as required by Section 6411 of the Patient Protection and Affordable Care Act (Pub. L. 111-148, enacted on March 23, 2010).
Summary: This amendment confirms that Tennessee intends on contracting with Recovery Audit Contractor(s) (RAC)s to audit Medicaid providers and review Medicaid claims submitted by provider of services.
Summary: Allows licensed pharmacists employed by an AHCCCS-registered pharmacy and acting within their scope of practice to administer seasonal flu and pneumococcal vaccines and anaphylaxis agents. AHCCCS-registered pharmacies will be reimbursed an administration fee for seasonal flu and pneumococcal vaccines and anaphylaxis agents administered by licensed pharmacists.
Summary: This SPA ensures compliance with the consultation requirements of Section 5006( e) of the American Recovery and Reinvestment Act. In Marylands case, it requires consultation with the one Urban Indian Organization (UIO) in the State, on Medicaid and Childrens Health Insurance Program SPAs, proposed waivers, waiver extensions, waiver amendments, and waiver renewals having a direct impact on Indians, Indian health programs, and/or UIOs.
