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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 this amendment makes grammatical revisions to reimbursement methodology for special facilities for ventilator-dependent patients and facilities with specially placed patients transferred from an acute care hospital setting to an approved NF on a prior authorized basis.
Summary: This SPA adds comprehensive substance abuse assessments, Level 1 Group and individual substance abuse counseling services and Level II Intensive Outpatient Services. Adding these services will increase payments to community-based substance abuse treatment programs.
Summary: This SPA proposes to place reasonable limits on the amounts of incurred necessary medical and remedial care expenses recognized under State law, but not covered under the State Plan.
Summary: To implement the required Asset Verification System for the purpose of determining eligibility for aged, blind and disabled Medicaid applicants and recipients in accordance with 1940 of the Social Security Act.
Summary: This SPA provides coverage to qualified alien children with incomes up to 300% of the Federal Poverty Level (FPL) and qualified alien pregnant women with incomes up to 250% FPL, in accordance with Section 214 of CHIPRA.
Summary: This amendment decreases payment rates to all hospitals by one percent, reduces a base year adjustment, eliminates payment for increased costs associated with a list of hospital acquired conditions, limits payments for certain child deliveries and adjust payment rates for an increase in costs for hearing tests.
Summary: To comply with the requirement of section 1903 (v)(4)(A) of the Social Security Act, this State Plan Amendment covers pregnant women and children under the age of 21 who are lawfully residing in the United States.