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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 plan amendment carves select outpatient hospital opioid antagonist drugs, which are otherwise compensated through the Enhanced Ambulatory Patient Groups (EAPG) payment methodology, out of the EAPG methodology and reimburses them at the lower of billed charges or the fee schedule rate.
Summary: This plan amendment updates the payment amount for the University of Colorado School of Medicine Supplemental Payment for Physicians and Professional Services rendered to Health First Colorado beneficiaries.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to increase behavioral health reimbursement rates.
Summary: Authorizes tribal Federally Qualified Health Centers (FQHC) to bill Colorado Medicaid for covered services on a per-visit basis under contract to the tribal FQHC.
Summary: 2.0% rate increase for outpatient hospital services per state budget bill, effective July 1, 2022. The amendment also modifies payments for new and out-of-state hospitals by creating more accurate groupings for calculating out-of-state and new hospital rates, effective September 1, 2022
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to increase the per-day rate for the Therapeutic Communities service.
Summary: allows the Arkansas Department of Human Services to amend their Long Term Care reimbursement manual to update its payment methodology for skilled nursing facilities. These revisions were necessary due to changes in the skilled nursing facility standards over the past several years.