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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 amends the current aggregate limits Pennsylvania uses to determine disproportionate share adjustment (DSH) payments for Inpatient DSH, Outpatient DSH and Direct Medical Education to qualifying hospitals.
Summary: Phase-out the use of the allowable MA costs incurred by county nursing facilities in calculating rates for MA non-public nursing facilities over a three year rate period beginning July 1, 2009, and ending June 30, 2012. Phase-in minimum occupancy requirements for MA non-public and county nursing facilities to receive reserved bed day payments for MA. Extend the provisions related to computing per diem rates for county nursing facilities that privatize through FY 2009-20I2. Eliminate the use of appraisals in the establishment of the fixed property component of an MA nonpublic nursing facilitys capital rate.
Summary: Extension of Medicaid Day One Incentive payments (MDOI) and funding levels for fiscal years (FYs) 2009-2010 and 2010-2011.Extension of Pay For Performance Incentive payments (P4P) to qualifying county nursing facilities for FYs 2009-2010, 2010-2011 and 2011-2012.
Summary: Pass-through payments to MA nursing facilites to recognize the MA portion of the health care-associated infection (HAl) surcharge levied by the Pennsylvania Department of Health.