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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: Clarifies that Episode of Care negative incentive adjustments will not exceed ten percent of the provider's gross Medicaid reimbursements received by the provider during the calendar year, rather than the performance period.
Summary: To implement a patient centered home which airms to improve efficiency economy and quality of care by rewarding high quality of care and outcomes encouraging clinical effectiveness promoting early intervention and coordination to reduce complications and associated costs and when provider referrals are necessary.
Summary: The Arkansas Title XIX State Plan has been amended to change Medicaid Reimbursement for Inpatient and Outpatient Hospital Services Covered by Medicare Part A and Medicare Part B Programs (Medicare Crossover Claims). Effective for all claims and claim adjustments with dates of service on and after October 1, 2014, the Division of Medical Services (DMS) will pay the Medicare Part A and B coinsurance and deductibles portions of Medicare services related to inpatient and outpatient Hospital services.
Summary: SPA adds changes to reimbursement for the MIC KEY Percutaneous Cecostomy tube MIC Button used tin the treatment of fecal incontinence. This also expands coverage of the MIC KEY Gastrostomy tube to include ages 21 and older.