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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 amendment revises methodologies and standards for determining payment rates for nursing facilities provided services based on the RUG class in effect.
Summary: Revises payment rates for providers specializing in the treatment of cerebral palsy, spina bifida, epilepsy, closed head injuries, and orthopedic conditions.
Summary: Revises the criteria for participation in the critical access dental program, and increases the payment rates for certain critical access dental providers.
Summary: Revising the state plan to provide reimbursement to Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) for behavioral health home services. Amendment also makes a technical revision to Alternative Payment Method I to reimburse behavioral health home services.