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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: The amendment was submitted to appropriately set the rates for Ambulatory Surgical Centers (ASC) at 80 percent of the current Medicare Ambulatory Surgical Center Payment System. This methodology further allows the Division of Medicaid to update the ASC codes and rates annually based on the Medicare annual updates.
Summary: Updates the description of Iowa's Medical Managed Health Care program to reflect the participation of a managed care organization in the program.
Summary: This amendment allows the Georgia Medicaid program to implement the Georgia SPA 12-001, Recovery Audit Contractors on April 1, 2012 in order to secure Medicaid Recovery Audit Contractors by this date.
Summary: This amendment allows self-direction for the less than 21 years old population eligible to self-direct their State Plan personal care services.
Summary: This State Plan amendment establishes a timeline of a look back period for the State to review Third Party Liability claims. Specifically this amendment will allow the Kentucky Department for Medicaid Services to look back three (3) years for payment for any healthcare item or services submitted not later than three (3) years after the date such item or services were provided.
