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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 transmitted a proposed amendment to your approved Title XIX State plan to implement changes to outpatient hospital reimbursements by reducing the cap on prospective interim payments (PlP).
Summary: This SPA codifies a one year timely filing requirement for all providers enrolled in the District's Medicaid Program. This requirement will increase the timely filing period to one year (365 days), clarify the beginning of the timely filing period when a claim is filed for a service when the beneficiary's eligibility was determined retroactively, clarify the policy when an initial claim is submitted within the timely filing period, and afford providers the opportunity to appeal a timely claims filing requirement.
Summary: This amendment updates the administrative practices, definitions, and procedures for State and Non-State Disproportionate Share Hospitals (DSH).
Summary: SF 2336, as authorized by the Iowa General Assembly, modified the maximum amount of disproportionate share hospital payments that could be paid to Groadlawns Medical Center.
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 455, Subpart E.
