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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: Description: This SPA adds coverage of routine patient costs associated with participation in qualifying clinical trials to Alternative Benefit Plan (ABP).
Summary: This SPA expand passive enrollment of the Medicare-Medicaid Coordinated Alternative Benefit Plan to three additional counties where there is only one participating health plan.
Summary: makes changes to the South Carolina Disproportionate Share Hospital (DSH) payment program, Medicaid Inpatient and Outpatient Hospital payment programs, and the Psychiatric Residential Treatment Facility (PRTF) payment program.
Summary: This amendment revises the supplemental payment methodology to Nursing Facilities (NFs) for state fiscal year (SFY) 2022. Specifically, Idaho Medicaid will utilize a one-year NF Patient-Driven Payment Model (PDPM) Upper Payment Limit (UPL) methodology to distribute supplemental payments to qualifying providers.
Summary: This SPA provides South Carolina with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: Increase rates for certain incontinence supplies, Substance Abuse and Addictive Disorder
services, autism spectrum disorder (ASD) services, and peer support services.
Summary: This SPA amends to add coverage of routine patient costs associated with participation in qualifying clinical trials to conform with the new regulatory requirements of 1905(a)(30) and 1905(gg) of the Social Security Act (SSA).
Summary: This plan amendment removes an add-on code for component-based vaccine administration and counseling and reference the correct fee schedule date.