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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 SPA clarifies how the premium assistance program determines if premium assistance is estimated to be cost effective and aligns with policies and current practice.
Summary: This amendment, effective January 1, 2023, updates All Patient Refined Diagnosis Related Group (APR-DRG) reimbursement rates for inpatient hospital services.
Summary: This SPA provides Arizona with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to temporarily extend the suspension of copay and premium requirements for all members originally approved in Disaster Relief SPA 20-0001.
Summary: This amendment updates methods and standards for establishing Medicaid Disproportionate Share Hospital (DSH)
payments to qualifying DSH hospitals using the FY ending 2021 base year cost reporting period to calculate interim DSH payments; updates the inflation rate used to trend the DSH base year cost to the end of the 2021 calendar year; updates swing bed and administrative day rates based upon the October 1, 2022, redetermination of nursing facility payment rates; and updates the statewide outpatient hospital fee schedule relating to Vagus Nerve Stimulation codes.
Summary: This amendment, effective October 1, 2020, updates the Arizona disproportionate share hospital (DSH) pool 5 payment amount and participant list, for the DSH state plan rate year ending 2021.