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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: Implements an increase to the resource standards for QMBs, SLMBs and QIs to conform to the resources limits for individuals who qualify for Medicare Part D Low-Income Subsidy.
Summary: Eliminates payment for three surgical errors known as "never events", eliminates payment for certain hospital acquired conditions identified as non-payable by Medicare and adds Anesthesiologiest Assistants as compensable provider type effective on or after February 1, 2010.
Summary: Enclosed is Ohios state plan amendment TN08-006 that contains new outlier services language proposed for adoption under Attachment 3. I A of Ohios state plan. This amendment also requests removal of existing sections contained under Attachment 4. l 9D, and removal of obsolete sections 5101 :3-3-54.l and 5101 :3-3-54.5 from Attachment 3. lA.
Summary: Makes technical corrections to the amendment originally approved with Transmittal #98-05 to correctly place and accurately reflect the financial criteria applicable for poverty level pregnant women.
Summary: Increase PMIC maximum rate to 1034 of the statewide weighted average for SFY 2010. Transition out-of-state placements to in-state and allow for Third Party Liability payments from other insurers for SFY 2011. Implement 100% cost reimbursement with cost settlement for state-owned PNIC.
Summary: This SPA modifies the methods and standards for making Medical Assistance payments to nursing facilities (NFs). Specifically, this SPA increases the net reduction factor in Maryland's rates for certain cost centers (Administrative/Routine, Other Patient Care, and Capital) from the current 4.816% to the proposed 8.681% effective August 1, 2009.
