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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 SPA makes conforming changes to the Medicaid State Plan under sections 9812 & 9822 of the ARP, which gives states the option to use a proxy methodology to account for the proportion of the individuals covered under the extended postpartum coverage option.
Summary: implements a 2.0% across-the-board rate increase for included services within SPA CO-22-0018 and targeted rate increases and rate decreases, per state statute
Summary: authorizes increased federal financial participation (FFP) for newly-eligible individuals receiving postpartum coverage and further includes the addition of Attachment D, which describes the special circumstances and other proxy adjustments that are applied to account for the proportion of individuals covered under the extended postpartum coverage option who would otherwise be eligible for coverage in the adult group and for the newly eligible FFP under section 1905(y) of the Social Security Act.
Summary: amends the provisions governing intermediate care facilities for individuals with intellectual disabilities (ICFs-11D) in order to allow a one-time lump sum payment from the dedicated funding pool.
Summary: sets an end date of March 31, 2022, for a previously approved one and one-half percent (1.5%) across-the-board payment reduction on hospital inpatient services.
Summary: updates the inpatient hospital reimbursement methodology for inpatient psychiatric services for individuals
under 21 admitted to Residential Rehabilitation Services for Youth (RRSY) programs certified by the New York Office of Alcoholism and Substance Abuse Services (OASAS), by adding a 5.4% statutory cost of living adjustment.
Summary: Updates the fee schedule effective dates for several Medicaid programs and services. This is a regular, budget neutral update to keep rates and billing codes in alignment with the coding and coverage changes from CMS