An official website of the United States government
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
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: Revises the payment methodology in Acute Level 2 settings of private psychiatric hospitals and general
hospitals with psychiatric units and in psychiatric residential treatment facilities (PRTFs), to allow an additional patient-specific specialty add-on per diem rate of $210 for children with specialized treatment needs
Summary: Limits adult visits in Federally Qualified Health Care (FQHC) and Rural Health Care (RHC) facilities to four visits per adult member per month, and to establish that reimbursement is made for one encounter per member per day in such settings, but with specific exemptions.
Summary: Increases the nursing facility pool amounts, base rate components for nursing facilities serving adults and Aids patients. Additionally, the SPA revises the Pay-for-Performance (PFP) program, formerly known as the Focus on Excellence (FOE) program.
Summary: Proposes to increase the nursing facility pool amounts, base rate components for nursing facilities serving adults and Aids patients. Revises the Pay-for-Performance (PFP) program
Summary: Reinstate the cost-based reimbursement to a State-owned Psychiatric Residential Treatment Facility (PRTF) rendering inpatient psychiatric services to individuals under the age of twenty-one.