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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: Deletes the obsolete covered service “Community Mental Retardation Clinics” and add “Methadone Clinic Services” for adults as a covered service
Summary: Proposes to implement a 5% reduction to the inpatient hospital add-on for capital and to reduce the impact from reconciliations of capital to actuals
Summary: Graduate Medical Education (GME) Payments are being submitted to allow the DIvision of Medicaid (DOM) to address calculations for GME payments for a hospital during a cap building period
Summary: This amendment proposes to decrease workforce salary for home health care workers by reducing the worker recruitment and retention by 25 percent for certified home health agencies and hospice programs
Summary: The State Plan has been amended to suspend all Episodes of Care, Asthma, Cholecystectomy (CHOLE), Chronic Obstructive Pulmonary Disease (COPD), Colonoscopy (COLON), Congestive Heart Failure (CHF), Coronary Arterial Bypass Graft (CABG), Perinatal, Tonsil, Total Joint Replacement (TJR), Upper Respiratory Infection-Non-Specific. Pharyngitis, Sinusitis (URI). Financially, the positive incentives (gain shai·e) now outweigh negative incentives (risk share).
Summary: makes changes to the MAGI-based income methodology in order to allow an alternative budgeting methodology for reasonable and predictable changes in income
Summary: Removes Imperial, Los Angeles and Sacramento Counties from and add Mariposa and Placer Counties to the list of geographic areas offering Targeted Case Management (TCM) services for the "Medically Fragile Individuals” TCM group.
